15.11.6.1 Rheumatology in childhood Flashcards
Describe the historical background of Peads rheumatology. Recap of basic connective tissue system recap of adaptive immunity and autoimmune disease recap of innate immunity and auto-inflammatory disease reflect on South African experiences. highlight common and relevant presentations and conditions in pediatric rheumatology in our local setting.
Rheumatic fever
correlation to athritis
What is paeds rheumatic
Embryonic development -3 germ layers focus on the mesoderm
mesoderm divisions
Cartilage
Tendons
Ligaments
Cartilage: tough,flexible,cushions and at the end of bones .
Tendons
Joints and their types
Connective tissue: muscles
innate immunity
adaptive immunity
Protects against almost any invader
adapts to antigen to be more specific ,memory
Central and peripheral tolerance
central: mechanism of tolerance to self-antigens in the bone marrow and thymus, which eliminates
Auto-immunity
Loss of immunological tolerance:
Immune attack on self
auto immune diseases
-
Risk factors for auto immunity
-Genetics
- Environment
-Loss of tolerance
Innate immune responses
Inflammation
Accumulation and activation of leukocytes
auto-inflammation: result of the disregulation fo the innate system
Auto-inflammatory conditions
Systematic juvinile diabetes
Tabulate the differences between autoinflammation and auto- immunity.
SA context: challenges facing children with JIA in SA
TB and HIV
Malnutrition
Poverty
Juvenile idiopathic arthritis
Most common form of chronic childhood arthritis and has 7 subcategories by ILR
Oligo(<4)-articular
common
Uveitis
Persistent type: >5 joints lating for 6 months
Systematic JIA
aoutoinflammatoty, the rest=auto immunity
Oligoarticular JIA
chronic asymptomatic uveitis is a major problem.
ANA + in 85%
leg length discripencies
Polyarticular
> 5 joints
RF positive<RF neg
TMJ Involvement
Enthesitis related arthritis
Usually older children, esp. boys over 6 years
stiffness when they wake up
Psoriatic JIA
Athritis plus:
psoriasis: hairline,look behind the ears
nail pits
dactylitis
1st or 2nd degree relative
Systemic JIA
athritis and fever:
-associated with with rash, salmon…
