Rheumatism
Rheumatism is a systemic disease characterized by inflammation of connective tissue. Predominant localization: cardiovascular system, musculoskeletal system – joints. Children and adolescents under 15 years of age are most often ill.
CAUSES AND PATHOGENESIS
The main cause of rheumatism is the defeat of hemolytic streptococcus group A. Streptococcus affects the upper respiratory tract. Rheumatism itself develops as a result of ineffective treatment of respiratory pathologies. Initially, betagemolytic streptococcus causes the following diseases: tonsillitis (sore throat), lymphadenitis, pharyngitis and others.
The risk group for rheumatism includes women, children under 15 years of age, persons with a family history of cases of rheumatism
When streptococcus enters the body, the immune system begins to produce specific antibodies to fight infection. Due to the physiological structure, the molecules on the surface of streptococcus are the same as some molecules on the surface of cells of the human body. Therefore, the body is unable to recognize its own and foreign cells, and antibodies destroy both. A person has similar molecules in the heart muscle and connective tissues. As a result of the immune attack, inflammation develops in the target organs, and subsequently the destruction of connective tissue, deformation and curvature of joints, the development of heart defects.
SYMPTOMS OF RHEUMATISM
As a rule, the first symptoms of rheumatism appear 2 weeks after angina, pharyngitis or other respiratory diseases. The patient complains of general weakness, malaise, heaviness in the body, as well as joint pain. Many patients have a subfebrile temperature, in severe cases of rheumatism, the temperature can rise to 28-39 degrees. Rheumatism affects large and medium–sized joints – knee, elbow. Wrist joints also hurt. The nature of the pain is specific – the pain comes on sharply and stops abruptly.
On the part of the cardiovascular system, the patient complains of palpitations, the heart rate can both accelerate and slow down. The patient is concerned about heart pain, interruptions in the rhythm of contractions, sometimes there is an anxious feeling. Next, the patient has shortness of breath, increased sweating – all signs of rheumocarditis. If the inflammatory process is not stopped at this stage, there is a high probability of developing heart defects that will require surgical intervention.
In rare cases, rheumatism affects the peripheral nervous system. Then the symptoms of such rheumatism will consist in: involuntary contractions of the muscles of the extremities, facial muscles. The patient’s movements become sweeping, pretentious, in the advanced stage the patient is unable to control his body. This syndrome is called “St. Vitus dance”, but it is more reasonable to use another term – “minor chorea”. Minor chorea most often develops in children 6-9 years old. Patients become whiny, capricious and disobedient, but not of their own volition and in connection with disorders of the nervous system.
diagnostics
Clinical blood test – determination of signs of inflammation
Biochemical blood test – determination of antibodies to beta-hemolytic streptococcus
Electrocardiography
Echography
Radiography
Joint biopsy
Diagnostic puncture of the joint for the study of articular fluid
treatment
The earlier the diagnosis is made and treatment is started, the more favorable the outcome of rheumatism. A patient with rheumatism is prescribed strict bed rest for a period of at least three weeks. Diet therapy is prescribed – fortified food, with an average carbohydrate content, food rich in fiber, rich in calcium and potassium, which has a beneficial effect on the heart muscle. Drug therapy includes the appointment of anti-inflammatory drugs, chondroprotectors, cardioprotectors, potassium and magnesium preparations. Prednisone, acetylsalicylic acid (aspirin) is also prescribed.
