CHICAGO, Ill. (Ivanhoe Newswire) — Is 14 too young for a hip replacement? About 300 thousand kids in the United States have juvenile rheumatoid arthritis. It is an autoimmune disorder, where the immune system malfunctions and attacks the joints. Treatments and medications may help some kids, but for others a more drastic option may be the only way to get long-lasting relief.
Despite her age, 19-year-old Emily Wegmann knows a lot about joint pain. At two she was diagnosed with juvenile rheumatoid arthritis. By 10, she was bone-on-bone on her left hip.
Emily explains, “I couldn’t even get myself dressed. I couldn’t do my hair. I couldn’t get myself to walk into school.”
Medications and steroids worked for short periods of time, but flare ups held Wegmann back during childhood.
Emily says, “Seeing my friends go out and me trying to keep up with them was very hard.”
Craig J. Della Valle, MD, Orthopedic Surgeon, Midwest Orthopaedics at Rush says, “Her arthritis was so aggressive that it was actually damaging her acetabulum on her hip socket.”
She developed an uneven leg length, which caused more pain in her knees, feet, and back. At 14, doctors recommended that Wegmann have a hip replacement and it worked. With new modern materials for hip replacements, her hip can last a really long time.
Dr. Valle explains, “It’s possible that this could last her longer than 20 years, 30, 40, 50 years and hopefully her lifetime.”
So far five years in, her right hip is still going strong. And she got her left hip replaced the summer before she started her freshman year of college.
Emily says, “Ever since then, I have been able to live like a normal teenager would.”
And truly enjoy her college experience pain-free.
Juvenile rheumatoid arthritis may not only affect the joints, it can also cause inflammation in the eyes, lungs, heart, liver, and other organs.
Contributors to this news report include: Milvionne Chery, Producer; Roque Correa, Editor and Videographer.
HIP REPLACEMENTS FOR JRA: HOW YOUNG IS TOO YOUNG?
BACKGROUND: Juvenile idiopathic arthritis (JIA) is a form of arthritis in children that causes joint inflammation and joint stiffness. It affects one or more joints for at least six weeks in a child aged 16 or younger. Adult rheumatoid arthritis is ongoing, chronic and lasts a lifetime, whereas children often outgrow JIA. However, the disease can affect bone development in a growing child. JIA is an autoimmune disease which means the body’s immune system attacks its own healthy cells and tissues. It can be caused by several things including genes and the environment. This means the disease can run in families but can also be triggered by exposure to certain things. It is linked to part of a gene called HLA antigen DR4. There is no single test to confirm the disease. A doctor will take into consideration a child’s health history and do a physical exam.
SYMPTOMS AND COMPLICATIONS: JIA can affect one joint or many. There are several different subtypes of JIA, but the main ones are systemic, oligoarticular and polyarticular. It depends on symptoms, the number of joints affected, and if a fever and rash are prominent features to determine which type a child may have. The most common signs and symptoms of JIA are pain. A child may not complain of joint pain, but you may notice them limping, especially first thing in the morning or after a nap. Joint swelling is common but is often first noticed in larger joints like the knee. In some cases, high fever, swollen lymph nodes or a rash on the trunk may occur, which is usually worse in the evenings. Serious complications can result from JIA. Some forms can cause eye inflammation and if left untreated can result in cataracts, glaucoma, and blindness. Eye inflammation frequently occurs without symptoms. JIA can interfere with a child’s growth and bone development. Some medications used for treatment, mainly corticosteroids, also can inhibit growth.
NEW RESEARCH FOR RHEUMATOID ARTHRITIS: Director of research at Shriners Children’s St. Louis, Farshid Guilak, PhD, is working towards a goal of developing rheumatoid arthritis therapies that have minimal side effects. His team has genetically engineered cells that, when implanted in mice, deliver a biologic drug in response to inflammation. The engineered cells reduced inflammation and prevented a type of bone damage known as bone erosion. Guilak says children are getting osteoarthritis from sports injuries as well as the increasing prevalence of obesity. “Our thought was, can we develop a system using living cells and get the cells to create these drugs in the body? In that way, the cells could continuously make and deliver biologic drugs used to combat arthritis,” Dr. Guilak said. A big concern with these drugs is that dosing is difficult, and if you suppress the immune system, the patients have an increased risk of infection and an increased risk for some cancers. The research team created a tiny disk about a quarter inch in diameter and about a millimeter thick that they can insert under the skin. It sits there dormant until it senses inflammation, then it turns on the drug that fights arthritis. Dr. Guilak says, “…we have some work to do, but we have all the pieces in place, and hopefully we will get to that eventually.”
* For More Information, Contact: Emily Wegmann, PR
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