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Causes and Symptoms of Juvenile Arthritis


Image is from Arthritis Foundation Blog

Juvenile arthritis is a disease that affects children ages 16 and under, and it involves inflammation of the tissue that lines the inside of the joints. This tissue is called synovium.

What are the Causes?

Most forms of juvenile arthritis are caused by a malfunction of the immune system, which places it in the category of autoimmune disorders. An autoimmune disorder occurs when the body attacks it’s own healthy cells and tissues. The result is inflammation of the synovium.

However, not all cases of juvenile arthritis are autoimmune. Another cause is labeled an autoinflammatory condition. The disease process behind an autoinflammatory condition is different from that of an autoimmune disorder.

While autoinflammatory conditions result in inflammation and involve an overactive immune system, the similarities between it and an autoimmune disease end there. With an autoimmune response, the body releases proteins called autoantibodies that attack the body. An autoinflammatory condition involves a more primitive part of the immune system, and the reason it malfunctions remains unknown.

What is Juvenile Idiopathic Arthritis?

Juvenile Idiopathic Arthritis is the commonly accepted term for the seven different types of arthritis that affect children. These are:

  • Systemic
  • Oligoarticular
  • Polyarticular with a negative Rheumatoid factor
  • Polyarticular with a positive Rheumatoid factor
  • Psoriatic
  • Enthesitis-related
  • Undifferentiated

What are the Symptoms of Juvenile Idiopathic Arthritis?

General symptoms include:

  • Joint pain
  • Tenderness
  • Stiffness
  • Warmth
  • Swelling

These symptoms last for more than six continuous weeks. The following symptoms are specific to each type of Juvenile Idiopathic Arthritis:

  • Systemic Juvenile Idiopathic Arthritis – Arthritis symptoms with or preceded by an intermittent fever that lasts for at least two weeks. One or more of the following symptoms accompany it: lymph node, liver, or spleen enlargement, inflammation of the lining of the lungs or heart, a flat, pale, pink rash that does not itch and can move from one part of the body to another.
  • Oligoarticular Juvenile Idiopathic Arthritis – Arthritis affecting one to four joints for the first six months of the disease.
  • Polyarticular Juvenile Idiopathic Arthritis (Negative Rheumatoid Factor) – Arthritis in at least five joints for the first six months of the disease and all tests for the presence of Rheumatoid Factor proteins are negative.
  • Polyarticular Juvenile Idiopathic Arthritis (Positive Rheumatoid Factor) – Arthritis in at least five joints for the first six months of the disease and two out of three tests for the presence of Rheumatoid Factor proteins are positive. Tests must be taken at least three months apart.
  • Psoriatic Juvenile Idiopathic Arthritis – Patient has both arthritis and psoriasis or arthritis and at least two of the following: a relative diagnosed with psoriasis, nail splitting or pitting, or inflammation of one entire toe or finger.
  • Enthesitis-related Juvenile Idiopathic Arthritis – This occurs where a joint capsule, tendon, or ligament attaches to the bone. The most common locations are the Achilles tendon behind the ankle and around the knee. Both arthritis and inflammation must be present or either one with at least two of the following: inflammation of the sacroiliac joint with inflammatory bowel disease or acute inflammation of the eye, enthesitis arthritis, arthritis in males over six years, a positive HLA blood test, a family history of ankylosing spondylitis, or inflammation at the base of the spine or in the lower back area.
  • Undifferiented Arthritis – Symptoms do not fit with any of the six previous categories.

Researchers now believe that both environmental and genetics play a part in the development of juvenile arthritis.


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Understanding Gluten Intolerance


Image is from Doctor Doni

Gluten is a protein that is found in wheat, barley, rye, kamut, spelt, and other grains. A gluten intolerance does not necessarily mean you have Celiac disease. There are many people who cannot tolerate gluten that do not test positive for Celiac disease. Tests for Celiac disease include:

  • Biopsy of small intestine
  • Reticulin antibody test
  • Endomysial antibody test
  • Transglutaminase antibody test

Many of the patients who tested negative for Celiac disease do have results that indicate they are gluten intolerant, however, which is a good starting point to receiving proper treatment.

How to Test for Non-Celiac Gluten Intolerance

The Gliadin antibody test is often positive when other tests, such as those above, are negative. While Gliadin antibodies will not result in a diagnosis of Celiac disease, they do indicate that your immune system is reacting against the Gliadin, which is a part of what makes up gluten.

Celiac disease is just another name for a condition called villous atrophy, which causes visible changes in the lining of your digestive tract. While villous atrophy can result from an immune reaction to gluten, it is only one possible result. In a nutshell, Celiac disease is just one type of gluten intolerance.

Other Tests for Gluten Intolerance

IgE and IgG are antibody tests for allergic reactions that can include numerous foods and food components. In this case, these tests are run to determine gluten intolerance. Most non-Celiac gluten sensitivity patients have elevated antibodies to:

  • Gluten
  • Gliadin
  • Barley
  • Rye
  • Wheat
  • Spelt

These patients usually feel much better after eliminating the foods they test positive for. In addition to several GI symptoms such as IBS, constipation, diarrhea, heartburn, bloating, or gas, patients with gluten sensitivity can also experience:

  • Headaches
  • Fatigue
  • Eczema or other skin rashes
  • Chronic sinusitis
  • Arthritis

What if You Already Know You Can’t Gluten?

According to Dr. Stephen Wangen, co-founder and Medical Director of the IBS Treatment Centers in Seattle, WA, and Los Angeles, CA, there are many patients who determine, through trial and error, that they can’t eat gluten. And if you have already found this to be true and have stopped eating gluten, it is highly likely that any tests run will come back negative.


The treatment plan for any type of gluten intolerance is as simple as it can be complicated: avoid gluten. It is complicated, because gluten hides in many foods that you would not think contained any gluten. One example of this is corn syrup. Corn syrup contains gluten and it is a very common ingredient in so many of our processed foods today. It is even most sodas, condiments, sauces, and ice creams.

Avoiding the list of grains above is the easy part, however, in order to maintain a gluten-free diet, you must read labels on every product you buy. It sounds daunting, but after a few trips to the store, you will have a good working knowledge of what you can and cannot digest. Then you will just have to read the labels on any food product you have never eaten before.

More and more grocery stores are now carrying a gluten-free line of foods and many of them are quite tasty. Again, you will go through a process of trial and error trying these new foods and determining whether you like them or not, but it is definitely worth it.

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