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Archive for Tuesday, February 13, 1996

ARTHRITIS

February 13, 1996

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Arthritis is a pain for the young as well as the old.

It started last winter with swelling in her finger joints, and occasional pain in her feet.

When 12-year-old Lauren Parsons of Lawrence finally complained about the pain after school one day, her mother rushed her to the PromptCare urgent care clinic at 3500 Clinton Pkwy., fearing her daughter had somehow injured herself.

But X-rays revealed no sprains or strains. The girl's family doctor, a local allergist and a pediatrician examined her in the next few months and all suspected that the Sunflower School sixth-grader had a form of rheumatoid arthritis, an autoimmune disorder, although blood tests didn't show any signs of it.

"It is surprising to Lauren and me that so few people realize that arthritis is not just a disease for the elderly," said her mother, Teresa Treanor.

Identifying the ache

Arthritis refers to any of more than 100 diseases that cause inflammation and pain in the joints between bones.

Inflammation of the joints can be a normal response to injury or disease. But an estimated 37 million Americans have joint pain and inflammation that doesn't subside, among them some 250,000 children. The inflammation itself can damage healthy tissue, resulting in a cycle of recurrent pain and sometimes wearing on joints so severely that they must be replaced.

"Obviously, for the kids with severe disease, people take notice very quickly," said Dr. Nancy Y. Olson, a pediatric rheumatologist and allergist at the Kansas University Medical Center, where Lauren was diagnosed last August with a form of juvenile rheumatoid arthritis.

In children with milder forms of the disease, parents may dismiss the symptoms as growing pains, or they may not recognize the signs of pain at all, such as awkward running or limping in the morning.

"Kids don't often give you as good a description as an adult might," Olson said.

Rheumatoid arthritis, and its juvenile forms, is among the most common form of the disease. Diagnosis can be made with blood tests and by ruling out other possible causes of the pain and inflammation. Blood tests are less reliable in children than in adults.

The causes of most forms of arthritis are unknown. Some forms appear to run in families, suggesting a genetic link. There's a history of arthritis in Treanor's family.

But researchers also suspect that viruses may play a role in at least some forms of arthritis. The viruses may trigger an inherited autoimmune response.

Twenty years ago, treatment of arthritis was largely limited to corticosteroids, which relieved the symptoms but not the underlying inflammation and swelling. They also had severe side effects when taken for extended periods.

Today, however, many nonsteroidal anti-inflammatory drugs are used to successfully treat the disease itself, sometimes well enough that it goes into remission. Chronic arthritis can recur throughout a lifetime.

Four drugs have been specifically approved for use in children: tolmetin, naproxen, ibuprofen and sulindac.

Because of the improved treatments, there's more publicity about the disease in children so the disease is probably diagnosed more often than it was two decades ago, Olson said.

Dealing with the pain

In the case of Lauren, now 13 and in the seventh grade at Southwest Junior High School, treatment with an anti-inflammatory drug hasn't helped much yet. Her hands and feet still hurt, but she persists with regular exercise, which doctors recommend for those with arthritis.

"It's aggravating," she said. "I try to deal with it as best I can. I do a lot of exercising -- dance and tennis and softball and gym. You know you have it all the time. The swelling never goes down a lot and it never gets really huge. But it hurts."

Her achy joints have also become accurate predictors of rain or weather changes.

"Mostly people think that it doesn't happen in kids at all," she said. "When I tell them I have arthritis and it hurts they think I'm using it as an excuse. And it's not. It happens to kids like me."

Lauren's parents have read as much as they can about the disease, so they know there's a chance the disease will go into remission as Lauren gets older.

Or, it may persist.

Her parents have also become supporters of the Arthritis Foundation, a national organization that funds arthritis research. Her father, Brad Parsons, co-owner of Marks Jewelers, 817 Mass., has donated a diamond to be given away in a Feb. 29 drawing for the Kansas Arthritis Foundation. For more information about the drawing or the foundation, call (800) 362-1108.

"Lauren has been a trooper through this," her mother said. "Her pain tolerance is high. It's very hard as a parent, and I want it to just go away. It's a sad thing when your child says that she can't remember how it feels to not hurt."

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