8-year-old girl with arthritis recovers after 3-year battle

Undetected arthritis among children can result in serious health issues including crippling, according to health officials. Most often than not the little ones continue suffering for long periods as the symptoms are rather deceptive. High fever accompanied by rashes would invariably be considered normal flu or allergy, say medics.

Mafraq Hospital is currently treating about 60 children between the ages of one month and 16 years who suffer from a form of paediatric arthritis.

Dr Leena Abu Shaqra, Consultant Pediatric Rheumatologist, Mafraq Hospital, the only paediatric rheumatologist in the UAE, say she has been treating a 11-year-old girl for past three years.

Dana Al Haj was first brought to her in 2007. Then aged eight, she suffered from bouts of high fever, rashes and inconsistent joint pain. Initially the parents had taken Dana to a nearby hospital, where they suspected a stomach bug then later diognised it as allergy. But the child showed no improvement and continued to run high temperature. She was then taken to another hospital, where more tests were conducted but Dana showed no improvement. For more than a month the child suffered from high temperature and pain while se ws being treated for virus infections.

At last she was brought to Dr Shaqra. "The moment I saw Dana I knew she was suffering from Juvenile Idiopathic Arthritis (JIA). She had the standard symptoms of a certain subtype – Systemic JIA. She was in a lot of pain and needed immediate treatment to reduce the symptoms, especially fever.”

Once fever subsided, symptoms of joint disease surfaced; she felt pain in her ankles and could not walk properly. She was prescribed Brufen and Volteran to lower fever and inflammation. Later she was given consistent doses of steroids and finally methotrexate, a treatment usually given to patients suffering from autoimmune diseases. 

Now, three years later, Dana experiences only minor flare-ups and has been in remission for more than two years.

Dana's case should help spread awareness among parents and society in general about paediatric arthritis.

“With adults, the rate of misdiagnosis of rheumatological diseases is high, so imagine how common misdiagnosis is with children suffering from such diseases,” asks Dr Shaqra. “I have patients who have been suffering for many years in silence. The symptoms are deceiving, such as fever and rash, and many doctors do not consider arthritis as one of the possibilities. Awareness is crucial in this matter. Especially with children a quick and accurate diagnosis is important, or else they can even be crippled."

Juvenile idiopathic arthritis is a chronic disease characterised by persistent joint inflammation; the typical signs of joint inflammation are pain, swelling and limitation because of of movement.

Systemic JIA is diagnosed by the presence of systemic features, besides arthritis. The main systemic symptom is represented by high spiking fever, often accompanied by a salmon-coloured rash that appears during fever spikes. Other symptoms may include muscle pain, enlargement of the liver, spleen or lymph nodes (groups of cells that filter out bacteria - a critical part of the immune system), and inflammation of membranes around the heart (pericarditis) and lungs (pleuritis).

The disease can affect children of any age.