What are rheumatism symptoms and illness? Rheumatism. Causes, symptoms and treatment of rheumatism Rheumatic process


Rheumatism is a recurrent inflammatory process of tissue, which is primarily provoked by the presence of beta-hemolytic streptococcus and is accompanied by damage to the tissue of the cardiovascular and other systems. An aseptic immune disorder is developing. This is the burning of the tissue that protects ligaments, tendons, and heart valves, caused not by bacteria, but by abnormal reactions to the immune system.

In this article you can learn about the causes, mechanism of development, symptoms, methods of detection and treatment of rheumatism in adults.

A decade ago, rheumatic attacks gave rise to a rapid development of heart disease and led to the development of important complications, and in some cases led to the death of the patient. However, the advent of antibacterial drugs has changed this situation and now sickness can not only be cured, but go to the stage of trival remission, so that practically no turbulence of the patient can develop.

According to statistics, women more often suffer from rheumatism, but after menopause their indicators are comparable. People of young ages and children aged 7-15 suffer from the risk of suffering, while young children, older and weaker people suffer less often. As a rule, rheumatism occurs first in the autumn or winter months; according to statistics, the frequency of culprits is around 0.3-3%.

Reason

Rheumatism develops over a period of time after infection caused by group A beta-hemolytic streptococcus.

The following symptoms of rheumatism can be caused by:

  • entry into the body of beta-hemolytic streptococcus group A;
  • or sore throat;
  • canopy fever;

After any streptococcal infection, approximately 97% of patients develop immunity, but in others such a dry reaction is not to blame, but the infection is then complicated by a rheumatic attack.

The following factors can contribute to the development of illness:

  • young age;
  • filth of communal minds;
  • severe hypothermia;
  • slackness.

After infection with beta-hemolytic streptococcus, the immune system begins to produce antistreptococcal antibodies, which create immune complexes in the blood together with antigens. Circulating in the body, stench begins to settle on the tissue of the cardiovascular system and provokes the start of aseptic (germ-free) necrosis.

Streptococcal antigens that appear in the blood have a toxic effect on the heart, and myocardial damage will worsen. With repeated penetration of the infection into the blood, hypothermia or stress attacks, this autoimmune reaction becomes even more pronounced, leading to a worsening and further progressive progression of rheumatism.

Rheumatic changes in healthy tissue occur in the following stages:

  • flour changes;
  • fibrinoid changes;
  • granulomatosis;
  • sclerosis.

With a mucoid disorder, collagen fibers swell and splinter. If this stage of illness is not cured, the fibrin fibers irreversibly collapse and fibrinoid necrosis of cellular elements develops. At the present granulomatous stage, zones of necrosis form around the cells of the cells to grow, and the cavity of rheumatic fever passes into the remaining stage of sclerosis (scarring).

The skin in the stages described above lasts for about 1-2 months, the entire cycle is 6 months.

Symptoms

After 1-2 days after repeated streptococcal infection, the patient develops the following symptoms:

  • raising body temperature to the highest levels;
  • tachycardia;
  • weakness;
  • swelling and soreness in the droops.

The stench is very similar to the original cold, but it is a streptococcal and not a viral infection. A characteristic symptom is pain and swelling of the great subglobular joints: elbow, ankle, knee, shoulder or metacarpus.

Arthralgia (global pain) with rheumatism is either mild or migratory. The stench initially appears in one of the corners, and then spreads to the others. Its character is multiplying and symmetrical. The skin over the thick forehead joints becomes puffy, blackened and hot on the chest. Suglob is sharply divided among Russia. After about a few days, the severity of these manifestations changes, but the dead ones remain in a troubling period.

  • partial pulse;
  • slobberiness;
  • unwell;
  • Reduced tolerance to physical demands.

Such symptoms appear in approximately 75-80% of patients.

  • poaching meats;
  • meat weakness;
  • apathy;
  • Develop on the skin: annular erythema and rheumatic nodules.

With ring-like erythema on the skin, a pale russet rash appears with the appearance of ring-like patches that spread on the toll and head. Rheumatic nodules are soft, painless, thick, round, numerous or solitary nodules, which are localized near the great or middle joints.

In case of a severe case of rheumatism, the organs of the calves, neck and legs suffer:

  • Through damage to the leg tissue, the patient develops signs of dry, exudative or pneumonia.
  • If the pathological process results in nephritis, then nephritis develops in the patient, which is accompanied by the appearance of red blood cells and protein in the area.
  • When the organs of the cerebrum are affected rheumatically, pain, vomiting and overstrain of the abdominal muscles occur through an inflammatory process.

Possibly complicated

The development of worsening rheumatism occurs due to severity, fatigue and continuity of relapses.

During the active stage, patients may experience heart failure. In addition, in case of too much exercise, illness quickly develops in the body and can lead to disability.

Diagnostics


The main manifestations of rheumatism are: apillar nodules, pain in the joints, chorea, annular erythema and rheumatic carditis.

Diagnostic signs and symptoms of rheumatism were classified as early as 1988 and divided into “small” and “great”.

“Mali” show rheumatism in the following way:

  • temperature rise;
  • arthalgia;
  • advancement of SHOE;
  • leukocytosis;
  • manifestations in the blood;
  • extending the P-Q interval by .

“Greats” show rheumatism the following:

  • myo-, peri-, and/or endocarditis;
  • podskirnye knots;
  • polyarthritis;
  • chorea;
  • ring-like erythema.

The following laboratory tests can confirm the fact that you have had a streptococcal infection:

  • blood test for antistreptokinase, antistreptolysin and antihyaluronidase;
  • culture for bacterial flora from the throat.

If at least 1-2 major and 2 minor criteria are identified and a previous streptococcal infection is confirmed, a diagnosis of “rheumatism” is made.

To clarify the tissue of the heart and other organs of the patient, the following investigations are carried out:

  • Ultrasound of internal organs;

Likuvannya

For active rheumatism, the patient is hospitalized. Bed rest is introduced to you. To relieve symptoms of rheumatism, the patient is prescribed the following medications:

  • Non-steroidal drugs: Indomethacin, Ibuprofen, Xefocam, Revmoxicam, Dicloberl and in;
  • hyposensitizing drugs;
  • Immunosuppressants: Azathioprine, Chlorobutin, Chloroquine, Hydroxychloroquine;
  • Glucocorticosteroids: Triamcinolone, Prednisolone.

Treatment with hormones at the same time rarely stagnates, and such methods are indicated only in some clinical episodes.

If the patient has an infection in the nasopharynx or throat, then further sanitation is carried out. In such situations, antibiotics, a number of penicillins and various antiseptic agents may be prescribed.

After acute rheumatic symptoms subside, the patient is recommended to take a bath at the resorts of the Pivdenny Coast of Crimea and Kislovodsk. Next, the sick person should periodically take treatments to improve the epiglobular tissues and a course of non-steroidal anti-inflammatory drugs.


Forecast


Patients with rheumatism are prescribed immunosuppressive, anti-inflammatory, antihistamine and other groups of drugs.

The prognosis for rheumatism depends on the severity of the damage to the tissues of the heart and blood vessels (which is evident in the scale of myocardiosclerosis, the nature of the damage to the heart valves). As soon as a rheumatic attack is relieved, the sickness will inevitably respond to treatment, and the life of the sick will not endanger anything. Recurrent rheumatism is the most unpleasant.

Rheumatism– inflammation of tissues, especially in the cardiac-vascular and musculoskeletal systems.

Another name for the illness: Sokolsky-Buyo disease, Gostra rheumatic fever.

Rheumatism SCL

ICD-10: M79.0
ICD-9: 729.0

Most often, rheumatism occurs in older children and toddlers, ranging from 3 to 15 years of age.

The development of rheumatism is provoked by a nasopharyngeal infection - which, when it enters the body, activates immune antibodies, which in turn begin to attack streptococcal molecules. The entry of streptococcus into the body causes illness such as, etc.

The problem lies in the fact that many similar molecules are found in the healthy tissue of the heart and blood vessels of people susceptible to rheumatism, and immune antibodies begin to attack them as well. In this way, an inflammatory process begins in the body, which is called rheumatism.

To eliminate rheumatism, we must first improve the immune system, and also prevent various infectious diseases from passing from acute to chronic forms.

Let's look at the signs of rheumatism.

Symptoms of rheumatism include:

Rheumatism of the skin. Characterized by rheumatic nodules, annular or nodular erythema, discrete hemorrhages, sweating, pale skin.

Rheumochorea (St. Vitus' Dance, rheumatism of the nervous system)- ignition process in the middle of the walls of the various blood vessels of the cerebrum. Characterized by the manifestation of fragmented brain vessels, rocine restlessness, furry activity, discoordination in Russia, muscle weakness, damage to the musculoskeletal system, mental disorders (aggression, bloatiness, Yes and no.).

Rheumopleuritis (rheumatism of the respiratory organs). It is characterized by pain in the chest, abdominal pain, elevated temperature, cough, and noise of rubbing the pleura.

Rheumatism of the eyes.Є storage of hidden manifestations of rheumatism in other organs. Characterized by damage to the retina (retinitis) and other parts of the eye (iritis, iridocyclitis, etc.). Complicated can become a part of the district.

Rheumatism of organs and etching. Characterized by disorders of the liver, as well as other organs of the gut-intestinal tract.

As expected from the beginning, the main cause of rheumatism is bacteria. Stinks can trigger the development of rheumatism:

Treatment of rheumatism is carried out comprehensively and focuses on eliminating streptococcal infection, improving immunity, as well as preventing pathological processes in the cardiovascular system.

Treatment of rheumatism is carried out in three stages:

1. Treatment of illness in a hospital

Inpatient treatment for rheumatism is aimed at eliminating streptococcal infection, as well as updating the functionality of the cardiovascular system. It includes:

- in case of acute illness, bed rest is prescribed;

- for the treatment of rheumatism, one drug from non-steroidal anti-inflammatory drugs (NSAIDs) and hormones is prescribed in combination or separately, depending on the etiology of the disease;

- for complete relief of illness, maintain the NSAID for 1 month or more;

- carry out antimicrobial therapy for 10-14 days with drugs of the penicillin series (“Bicilin”);

- if the symptoms of rheumatism often worsen or the illness is accompanied by other illnesses, the cause of which is streptococcal infection, for example, chronic tonsillitis, the period of treatment with penicillin increases, or additional symptoms There is another antibiotic: "", "Amoxicilin", "Clarithromycin", "Roxithromycin", "Cefuroxime axetil" and in.

- “Prednisolone” is indicated, in an individual dose, for laboratory tests, which is taken in an initial dose for the first 10 days, after which the daily dose is reduced by 2.5 mg for 5-7 days , and so on until you take the drug again;

- it is indicated to take quinoline drugs, which are taken for a period of 5 months to several days after illness;

- in cases of serious pathological processes in the throat area, the doctor may indicate the removal of tonsils.

2. Renewal of the immune and cardiovascular systems

Renewal of the immune and cardiovascular systems should be carried out mainly in health centers (sanatoriums), such as:

- Continue to carry out anti-rheumatic therapy;
- If they are still deprived, they suffer from various chronic illnesses;
- Prescribe a diet that includes, first of all, the hedgehog, the rich;
- Indicate the preparation of the body;
- Indicate recreational physical education.

3. Periodic consultation with the doctor

Periodic consultations with the doctor are carried out at the local polyclinic, which is aimed at inducing remission of rheumatism, as well as preventing its illness.

In addition, at the 3rd stage of treatment for rheumatism:
- continue to administer penicillin-type drugs in small doses (1 time every 2-4 days for 1 day);
- conduct instrumental and laboratory investigations 2 times per river;
- Provide special physical education;
- continue to boost your immunity with vitamins;
- 2 times per river, in the spring and spring, in order of stagnant penicillin, carry out a one-month course of taking non-steroidal anti-inflammatory drugs.
- if you overcome the illness without being related to heart problems, continue to take penicillin-type drugs for 5 days after treating rheumatism.

Important! Before taking any folk remedies, please consult your doctor.

Propolis. Form a shortcake from the propolis, which you apply to sick people before bedtime. It’s important to wrap it with some hustka so that it’s deprived of warmth.

Compress with propolis. You can also grate propolis, then add wine alcohol. Make sure to spend 10 days in a dark place, when you need to get it. On the 11th day, cool the tincture for 10 years in the refrigerator and strain. Otrimaniy zasib vikoristovat yak kompresi until ill place. Wrap the top of the compress with cotton wool to further warm the place. Only you need to handle the skin carefully, since the skin is damaged in a sick place.

Propolis ointment. Propolis ointment has significant analgesic, regenerative and anti-inflammatory properties. To prepare it, you need to add about 100 g of Vaseline, then cool it to 50°C and add 10 g of the desired propolis. I can put it on the stove and cook another 10 quilins under a covered lid. Then cool, filter through gauze, apply to the plot 2 times a day (morning and evening).

Pine heads. Fill a liter jar with herbal pine needles, then fill them with normal medicinal alcohol. Close the jar tightly with a lid and let it sit in a warm, dark place for 3 minutes until it’s done. After 3 further procedures, remove the mixture through gauze and take 8 drops per piece of cuticle in front of the hedgehog 3 times a day for 4-6 months.

Birch leaves. Stuff your clothes with birch leaves so you can sleep with them. Cover yourself well so you can sweat. You need to sleep this way, otherwise you can’t fall asleep, then just sweat in the sheets for 3-4 years and you can take them away. Another popular folk remedy for rheumatism is birch baths. To do this, you need to fill the bath (30-50%) with birch leaves, let them steam, and then take a bath for 1 year.

Akonite(be careful, aconite is a waste of roses). To prepare the rejuvenation of the same underwater 50 g of the roster Jungarsky Akonit, to flood 500 g of Gorilka, Pirogo Chogo Krivo Krishko I Put the Porogliy 2 Tizhni in the dark Mass, periodically Zbovnoyi VSYB. Then process and store it in the refrigerator. It is necessary to rub the ailing area with the infusion, then wrap it in flannel and tie it with warm cloth. After removing the compress, wash the area with cold water.

Tincture of aconite. Pour 2.5-3 g of dried aconite root into 100 g of burner. Place in the dark for 2 minutes, stirring occasionally. Then strain and take 1 drop per hour. For a further 10 days, add 1 drop 3 times a day, also every hour. On the 11th day, take 10 drops over 3 doses. On the 12th day, pick up one drop. The treatment course is carried out 3 times, with a break of 5 days.

Let's get out of aconite. Place 10 g of aconite root in a saucepan and pour 500 g of water into it. Cook for 2 years on high heat. Then let it cool, strain and rub it on the plot 3 times a day.

Omega-3. Omega-3 has a significant anti-inflammatory, pain-relieving and pain-relieving effect not only in rheumatism, but in arthritis, arthrosis and other diseases of the musculoskeletal and cardiovascular systems. In addition, Omega-3 has a miraculous effect against old age.

Rheumatism is one of the systemic diseases of healthy tissue. The pathology manifests itself in the appearance of a progressively progressive tissue disorganization. The development of illness is based on immune reactions that occur in the body’s tissues, so they can be called pathological.

What is rheumatism?

Rheumatitis, what is it? This illness, which is based on streptococcal infection and hypersensitivity reactions, is more important than the heart and blood vessels, in which it develops during periods of congestion and remission. The period of congestion is called a rheumatic attack. In front of us, it attacks the heart, the judiciary, the limbs, the nervous system, sometimes the muscles, the legs, and the skeletal muscles.

Cause the factories to provoke the development of illness

Many people can develop rheumatism caused by group A beta-hemolytic streptococcus, whose antigens overreact. When the immune type is formed, antibodies develop that cross-react with bacterial antigens and heart tissue proteins, similar to streptococcal antigens.

Streptococcus sees exotoxins that destroy the elements of healthy tissue, resulting in the formation of antibodies to antigens, which create the basis for the development of processes involving autoimmunization. As a result, illness becomes permanent with periodic relapses.

Rheumatism develops due to age-old and genetic factors. There is a tendency to develop sickness, which most often occurs between 7 and 15 years.

The basis of the pathology is the systemic disorganization of healthy tissue, all stages of which can occur in the tissue of the heart:

  1. Boroshnov swelling. This phase is still reversed. The swelling of the main material of the fabric is to blame.
  2. Fibrinoid swelling. This is an irrevocable phase, which is accompanied by the penetration of collagen fibers by plasma proteins.
  3. Cellular ignition reactions. In the middle of the process, macrophages accumulate, which are oriented toward the fibrinoid, which leads to the formation of granulomas. This is specific to rheumatic granuloma.

The cycle of formation of granulomas lasts 3-4 months, after which there is a change in the phases of remission and attacks, which are characterized by rheumatism, symptoms in adults and children associated with the cycles of granuloma growth. Macrophages and other leukocyte cells under the influence of fermented granulomas see lysosomal enzymes that spread into excess tissue, resulting in symptoms characteristic of illness.

Symptoms and mechanism of development of pathology

Sickness is characterized by an attack of the heart, in which either 1 or all 3 membranes can become inflamed, which influences the character and strength of the manifestation of symptoms.

Signs of rheumatism:

  1. Endocarditis. Behind the place of culprit inflammation you can see the valvular, chordal and parietal. In case of endocarditis, hydration of the endocardial tissue, degeneration of the endothelium, and infiltration from leukocyte cells in the affected endocardial tissue are avoided. As a result of endocarditis, endocardial sclerosis develops. Tse nabuta vada sertsya.
  2. Myocarditis. In any form of inflammation, necrosis of the myocardial cells is avoided, which leads to the destruction of the heart’s sensory function. Particularly dangerous is the destruction of the robotic hooks.
  3. pericarditis. There are serous, serous-fibrinous and fibrinous.

Damage to blood vessels, especially capillaries and arterioles, is called rheumatic vasculitis. In 10-15% of patients, swelling of the joints increases. This condition is called polyarthritis.

After 1-2 weeks of suffering from a streptococcal infection, the temperature may rise to 38-39°C, which is accompanied by weakness and headaches. Symptoms of rheumatism in adults occur due to the fact that the tissue is first affected. The most early symptom of illness is rheumatic pain that occurs in the joints. Great joints are the first to be affected: knee, shoulder, elbow, etc.

After an hour, shortness of breath, increased heart rate, heart pain, increased sweating are detected. These symptoms indicate the beginning of a rheumatic inflammation of the heart. In the world, the development of illness is due to swelling, congestion, which is a sign of heart failure, which occurs through sclerosis of the heart and changes in its short-term health.

The most common culprit is the leakage of the left atrioventricular valve, which connects the left sac and the atrium, which causes insufficient circulation in the large volume of blood flow and stagnation of blood in the small one.

Through the development of vasculitis in the brain and spinal cord, it is possible that the nervous system is affected, which is associated with necrosis of neurons. This is the cerebral form of rheumatism.

Diagnostics and treatment

One of the most important diagnostic signs is the presence of a large number of antibodies to streptococcus in the blood, which indicates a streptococcal infection. Looking at whose polyarthritis, chorea, carditis serve as these signs, emerging from any diagnosis of rheumatism, treatment is based on the use of drugs that suppress the inflammation of organs.

Therapy is carried out at the discretion of the hospital, anti-inflammatory drugs such as corticosteroids and substances of a non-steroidal nature are treated. Prednisolone and Triamcinolone can be added to steroid drugs. These hormonal effects, which a doctor may treat, should be treated with caution. Non-steroidal drugs are more often used: Ibuprofen, Diclofenac, etc.

Treatment of rheumatism also requires suppression of streptococcal infection, which requires antibiotics: Penicillin and other analogues. They reduce the proliferation of microbes in the body, preceding the creation of antibodies.

Such a comprehensive treatment, which consists of anti-inflammatory and antibacterial properties, is the most optimal scheme that helps to combat a rheumatic attack.

Forecast and prevention

The complications of rheumatism are associated with underlying heart defects, which can provoke thromboembolism. Through a decrease in the pumping capacity of the heart and the formation of thromboembolism, organ hypoxia occurs, which can cause dystrophic changes. With steady monitoring from the doctor and recurrent illnesses, the patient can live a long time. With rheumatism, it is most unsafe to take a bath, which can lead to sclerosis of the heart, which can cause decompensated vada.

The main prevention of illness is the early detection and treatment of streptococcal infection, which overcomes the high level of antibodies. Therefore, it is important that if you have a severe sore throat, you should contact a doctor, who will determine the severity of your illness and the need for treatment.

Rheumatism is a systemic inflammation of healthy tissue with an important localization of the process in the cardiovascular system. The development of rheumatism is closely associated with anterior acute or chronic nasopharyngeal infection caused by group A streptococcus, direct or indirect influx of its components and toxins into the body with development moonlight.

Rheumatism is a widespread disease, which affects people of all categories. In children aged 5-15 years, rheumatism is acute rheumatic fever, which responds well to treatment with relatively low risks of further deterioration. In older people, rheumatism is chronic, and in most cases, the heart is affected by the head.

See rheumatism

Rheumatism is more complicated from the clinical point of view of illness with a given classification. The most common types of rheumatism are: rheumatic carditis, polyarthritis, chorea, skin rheumatism and pneumatic pleurisy.

Treat rheumatism

Treatment of rheumatism is based on early, complex therapy aimed at suppressing streptococcal infection and the activity of the inflammatory process, as well as at the affected development or progression of the heart.

The implementation of these programs follows the principle of stages:

  1. inpatient hospital,
  2. additional bathing in the local cardio-rheumatological sanatorium,
  3. dispensary at the polyclinic.

At the first stage in the hospital, the patient is treated with medicinal treatment, food correction and physical exercise, which are determined individually depending on the characteristics of the illness and the severity of the heart condition.

In cases of streptococcal nature, rheumatism is treated with penicillin.

  • Antirheumatic therapy includes one of the non-steroidal anti-inflammatory drugs (NSAIDs), which are prescribed in isolation or in combination with hormones and are indicated.
  • Antimicrobial therapy with penicillin is carried out for 10-14 days.
  • For the presence of chronic tonsilitis, in case of frequent acute infections, the use of penicillin will increase or additionally use another antibiotic - amoxicillin, macrolides (azithromycin, roxitrom icin, clarithromycin), cefuroxime axetil, other cephalosporins in a secular dose.
  • Non-steroidal anti-inflammatory processes stagnate for at least 1-1.5 months until the sign of activity in the process subsides.
  • Prednisolone at an initial dose is prescribed for 10-14 days until the effect is maintained, then the additional dose is reduced by 2.5 mg every 5-7 days under the control of clinical and laboratory indicators, after which the drug is discontinued.
  • The effectiveness of treatment with quinoline drugs for rheumatism can last for several months, up to 1-2 years or more, depending on the illness.

In the hospital, the hospital also carries out the elimination of chronic inflammation of the infection, stopping the operation from removing the tonsils, which will take effect after 2–2.5 months from the beginning of illness within a day, a sign of the activity of the process su.

The main tasks at stage II are to achieve a new remission and update the functional capacity of the cardiovascular system. The sanatorium will continue to provide inpatient therapy, treat the outbreaks of chronic infection, and maintain a consistent medicinal health regimen with differentiated urinary activity, medicinal function culture, procedures, what to do.

The third stage of complex therapy for rheumatism involves the prevention of relapses and progression of illness. For this purpose, use penicillin preparations with prolonged action, especially Bicilin-5, before administering any treatment during inpatient treatment, and then - once every 2-4 years. Regularly, 2 times a day, carry out outpatient fasting, which includes laboratory and instrumental methods; indicate necessary wellness visits and physical exercise. In case of rheumatism without heart disease, bicilinoprophylaxis should be carried out for 5 days after the last attack. In the spring-autumn period, due to the spread of bicilin, a monthly course of NSAIDs is indicated.

Prognosis for rheumatism

The prognosis for a person who is ill with rheumatism depends, first of all, on the timeliness of diagnosis and treatment. The most unsafe treatment for rheumatism is that the heart is in the acute phase, during which time it is important to undergo a course of treatment with the required antibiotic.

Children and young children are most at risk, and even in this case, the illness most often causes a hardening of the heart. Older people tend to be more likely to suffer from rheumatism and have a favorable prognosis. A significant influence on the prognosis for rheumatism is the number of relapses, so great attention should be paid to their prevention.

Prevention

Prevention of rheumatism is divided into primary and secondary.

Primary prevention is aimed at preventing rheumatism and includes:

  1. Improvement of immunity (preparing, supplementary food, complete nutrition, etc.).
  2. Detection and treatment of acute and chronic streptococcal infection.
  3. Preventive measures in children susceptible to the development of rheumatism: from families with episodes of rheumatism or other rheumatic illnesses; often suffer from nasopharyngeal infection; suffer from chronic tonsillitis or have suffered from streptococcal infection.

Secondary prevention is aimed at preventing relapses and progressing illness in patients with rheumatism in the minds of dispensary monitoring.