Ankylosing Spondylitis in Children
Anyone can develop ankylosing spondylitis, even children. It’s a type of arthritis that attacks the spine. When it’s found in a child, it’s called juvenile ankylosing spondylitis (JAS). Boys are more likely than girls to develop JAS. The disease often appears during the teen years. It also tends to run in families. Experts think it may be partly genetic. Many cases of JAS occur in children with a gene called HLA-B27. But not all children with this gene develop JAS.
Symptoms of JAS
Like other types of arthritis, JAS causes pain and stiffness. The spine and other nearby joints, such as the hip, become inflamed. In serious cases, the disease may break down the joints. Bones may even fuse together.
Symptoms of JAS may come and go. They often include:
Back pain, especially at night while resting
Joint pain, especially in the legs
Body aches, such as in the shoulders, buttocks, or heels
Stiffness in the morning
Stooped posture to ease pain
Problems inhaling deeply if AS affects the joints between the ribs and the spine
Lack of appetite
Extreme tiredness, or fatigue
Lack of healthy red blood cells, called anemia
Poor weight gain
Some children with JAS also have skin rashes and stomach illnesses. They may have eye problems, too. These include pain, redness, and sensitivity to light. Severe cases of the disease may damage organs such as the heart and lungs.
To diagnose JAS, your child’s healthcare provider will start with a physical exam. He or she will ask about your child’s symptoms and medical history. An X-ray or MRI may be used to check your child’s spine and other joints. This may show joint damage. Genetic testing can find out if your child has the HLA-B27 gene.
Your child’s provider may also recommend a lab test that checks for inflammation. This test is called an erythrocyte sedimentation rate test. It measures how quickly red blood cells fall to the bottom of a test tube. If your child has inflammation from arthritis, the red blood cells will clump together and fall faster.
JAS can’t be cured. But treatments can ease pain and stiffness. They can help your child live a more active life. Your child’s provider will choose the best treatment based on your child’s overall health, the severity of the disease, and other factors.
Several types of medicine can reduce pain and inflammation. These medicines include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen
Disease-modifying antirheumatic drugs (DMARDs)
Regular exercise can help ease your child’s symptoms. He or she should do exercises that strengthen the back. Your child’s healthcare provider may also suggest physical therapy. Teaching your child to have proper posture is important, too.
June 14, 2018
Original article: 85-p00045, Taurog, JD., Ankylosing Spondylitis and Axial Spondyloarthritis, New England Journal of Medicine (2016); 374; 2563-2574.
Bass, Pat F. III, MD, MPH,Horowitz, Diane, MD