Online ISSN: 2515-8260


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Rohatoy Takhirova, Shakhnoza Abzalova, Gulchehra Pirnazarova, Kamola Yakubova, Dilafruz Ibragimova


Abstract. Rheumatoid arthritis is a systemic inflammatory progressive disease of the connective tissue with a predominant lesion of small joints of the type of erosive-destructive polyarthritis of unknown etiology with complex autoimmune pathogenesis, which often leads to combined pathology of the body and disability of children and adults. The disease is characterized by a rather early manifestation of high disability (70%). The main causes of death from the disease are infectious complications and renal failure. Treatment focuses mainly on pain relief, slowing the progression of the disease and repairing injuries through surgery. Early detection of the disease using modern means can significantly reduce the damage that can be done to joints and other tissues. The first cases of manifestation can be recorded after severe physical exertion, emotional shock, fatigue, during hormonal adjustment, exposure to adverse factors or infection. With all this, it is necessary to study the intersystemic relationships of this disease. In this regard, the goal of our research is to study the relationship of immunological parameters and indicators of the endocrine system in rheumatoid arthritis in children. We examined 98 children, 58 of which were girls (59%) and 40 boys (41%) aged 7 to 17 years with the JRA. The duration of the JRA ranged from 6 months to 7 years. Among the patients examined by us, about half were children with a disease period of 1-3 years. The articular form of the disease was observed in 66 children (the maximum activity of the disease was in 19, moderate in 27, minimal in 20), articular-visceral in 32. The control group consisted of 20 healthy children of the same age. The results of our studies showed that with rheumatoid arthritis, depending on the form of the disease in children, there was a high level of TSH and ACTH and a low content of T3, T4 and cortisol. With prolonged exposure to stress, the excretion of hormones by the effector glands decreases and the level of pituitary hormones increases according to the principle of negative feedback. A similar type of endocrine system functioning has been identified in children with rheumatoid arthritis. There are also significant changes in the immune status: the content of T-lymphocytes in the blood decreases and the activity of the B-system of immunity increases. Depending on the severity and form of the disease, the closeness of correlations was also revealed. Based on this, our observations of children with articular rheumatoid arthritis over three years showed that changes in the parameters of the immune and endocrine systems persist. The inclusion of glucocorticoid hormones in therapy in patients with articular-visceral form of rheumatoid arthritis showed a positive dynamics of indicators, the state of the immune, as well as the endocrine system. Treatment of patients with glucocorticoid drugs only improved the course of the disease, but did not eliminate the process itself.

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