Nervous arthritic diathesis.

Better known as “uric acid diathesis”, neuroarthritic diathesis is a disease that occurs as a result of metabolic failure and manifests itself as excessive excitability of the central nervous system and some other symptoms, in particular, allergies.

The onset of the disease is usually associated with unfavorable heredity and a number of external factors, for example, with improper nutrition, both of the child and the mother during pregnancy.

ICD 10 code

• M 05 – M 14 – inflammatory polyarthropathy.
• M 10 – gout.
• M 10.3 – gout caused by renal dysfunction.
• M 10.4 – other secondary gout.
• M 10.9 – gout, unspecified.

Causes of neuroarthritic diathesis

The main cause of the disease is considered to be genetically determined inheritance on the maternal, but more often on the paternal line. Neuroarthritic diathesis can occur in a child whose parents suffer from gout, calculous cholecystitis, urolithiasis, obesity, diabetes mellitus, ischemic heart disease, atherosclerosis. Metabolic disorders are inherited first of all.

Secondary factors in the development of the disease are considered to be:

• poor nutrition of the mother during pregnancy (for example, following a protein diet);
• improper nutrition of the child (predominant consumption of foods that contain a large amount of animal protein - for example, meat, offal);
• negative environmental factor.

The pathogenesis of neuroarthritic diathesis includes the following disorders:

• high excitability at any of the reception stages;
• disorder of purine metabolism with increased content of purines in the blood and urine;
• decrease in the acetylating property of the liver.

Many scientists suggest that neuroarthritic diathesis is inherited in an autosomal dominant manner with reduced penetrance, especially in females. There is also a hypothesis of polygenic inheritance. This once again proves the importance of external factors in the development of the disease.

The predisposition to allergies and other pathological reactions in patients with neuroarthritic diathesis is also explained by the fact that one of the properties of uric acid is the inhibition of the production of cyclic nucleotides. A decrease in the amount of sugar in the blood, increased lipolysis during starvation (for example, with repeated vomiting, pathological lack of appetite), during infections, stress, excessive intake of animal fats with food lead to ketogenesis and the formation of ketoacidosis with a possible comatose state.

As a rule, by about 10 years of age, the child’s acetonemic attacks disappear.

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Symptoms of neuroarthritic diathesis

The clinical picture of neuroarthritic diathesis depends on the type of disease. There are 4 such types, which are distinguished under the form of neurasthenic, cutaneous, spastic and dysmetabolic syndromes.

• The first signs of neurasthenic syndrome are the appearance of an unfounded feeling of anxiety, worsening and shortening of sleep in the baby. As the child grows older, he becomes more and more excitable and can react violently to the slightest touch.

After the child reaches 2 years of age, he begins to noticeably outpace other children in development. At this time, the following signs are also observed:

• mood instability, capriciousness, irascibility;

• motor excitation;
• insomnia, anxiety;
• increased sensitivity to odors;
• unexplained bouts of vomiting or coughing;
• manifestations of enuresis;
• loss of appetite, weight loss (in girls, on the contrary, weight gain is sometimes possible);
• speech disorders (possibly stuttering, too fast and hesitant speech);
• pain in muscles, in the abdomen, in the head;
• excessive defecation;
• the smell of acetone from the mouth (mainly in the morning).

Signs of dysmetabolic syndrome appear in older age:

• joint pain (usually at night) due to crystallization of urates in the synovial fluid;
• pain and burning sensation when urinating (due to damage to the mucous membrane of the urethra by salt crystals);
• acetonemic crisis (increased levels of ketone bodies in the blood).

In turn, the symptoms of acetonemic crisis are considered to be:

• epigastric pain with increased temperature;
• sudden weight loss;
• loss of appetite, dehydration;
• in severe cases – loss of consciousness, convulsions.

The crisis can last from 2 hours to 4-5 days, after which there is a sharp improvement in the condition of the sick child. •

The clinical picture of spastic syndrome is expressed in the following symptoms:

• bronchospasm;
• migraine;
• heart pain;
• difficulty with defecation;
• increased blood pressure;
• renal and intestinal colic.

Development of a mild course of bronchial asthma is possible.

The first signs of skin syndrome are detected at about 10 years of age:

• urticaria-like rash;
• angioedema, eczematous rash, atopic dermatitis.

Neuroarthritic diathesis is diagnosed in children much more often than in adult patients. However, among all the types of diathesis that occur, this disease is detected in only 2.5% of cases.

Consequences and complications of neuroarthritic diathesis

Neuroarthritic diathesis implies the body's tendency to develop certain pathological conditions. The disease can develop into damage to the urinary system (kidney stones, nephropathy, nephritis), and excess uric acid in the bloodstream can provoke the development of gout and joint inflammation.

Disturbed metabolism in neuro-arthritic diathesis often causes endocrine disorders (diabetes, obesity), atherosclerotic changes in blood vessels, heart disease. Regular irritation of the central nervous system can lead to neuralgia, migraine and various manifestations of neurological symptoms.

In order to avoid such consequences, it is important to start treatment of metabolic disorders in a timely manner, as well as strictly adhere to recommendations regarding lifestyle and nutritional principles.

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Diagnosis of neuro-arthritic diathesis

The defining diagnostic procedures for neuroarthritic diathesis are urine and blood tests and some other methods.

• Urine analysis is one of the most informative for diagnosing neuroarthritic diathesis. In addition to the color and other external assessments of the urine, attention is paid to the chemical composition. Even at the onset of the disease, an increased number of salt crystals in different combinations is determined. The predominant content of certain salts indicates the formation of certain deposits, which helps to correctly select a treatment regimen.

• Blood tests can indicate the development of inflammation, as well as identify the level of urea, nitrogen, creatinine. The content of these substances is a determining factor in the development of diathesis.
• Instrumental diagnostics is represented, first of all, by ultrasound examination – this is the type of diagnostics that is used already at the first signs of the disease. Salt crystals are detected on the ultrasound image as echo-positive inclusions, and as the process increases, elements of sand and stones can be seen.
• Before the use of ultrasound, the main diagnostic method was considered to be the radiography method, which in recent years has been used only to clarify some details. Stones smaller than 0.3 cm, as well as urates, are not displayed on the X-ray.

Differential diagnostics are carried out with all sorts of neuroses, rheumatism, infectious arthritis, pyelonephritis, chronic infectious diseases, chronic pancreatitis and cholecystitis. In addition, there is such a congenital defect of purine metabolism as Lesch-Nyhan syndrome.

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Treatment of neuro-arthritic diathesis

The fundamental principles of treating neuroarthritic diathesis are considered to be adherence to a certain regimen and diet. A sick child should be protected from stress, excessive intellectual loads. Parents should not allow such a child to watch TV or play on the computer for a long time.

Hardening procedures, morning exercises, and walks in the fresh air will be beneficial.

Medicines are prescribed in a course, up to 2 times a year:

• mineral and vitamin-mineral preparations with mandatory content of potassium and calcium;
• anti-inflammatory drugs (non-steroidal drugs);
• hepatoprotectors (gepabene, carsil, essentiale);
• agents that reduce uric acid production;
• sedatives (valerian, novo-passit, phytosed).

When signs of an acetonemic attack appear, the following treatment is used:

• orally glucose water, tea with sugar, fresh juice, alkaline water without gas;
• drinking liquid every 10-15 minutes;
• feeding on demand, low-fat and carbohydrate foods;
• bowel cleansing (an enema can be used);
• hepatoprotective drugs;
• cyanocobalamin orally or intramuscularly;
• in case of debilitating attacks of vomiting and dehydration – intravenous infusions of glucose solutions, saline, vitamin C, etc.

Surgical treatment is used in the case of full-blown urolithiasis against the background of neuro-arthritic diathesis. Large stones are removed by surgical operation. Small formations are subject to fragmentation by electromagnetic waves (remote lipotripsy procedure).

However, even surgical treatment cannot guarantee a complete cure for the patient. Removal of stones does not prevent their further formation. The patient must follow dietary changes and periodic preventive treatment throughout his life.

Homeopathy for neuro-arthritic diathesis

Homeopathic doctors are confident that, thanks to the holistic approach of homeopathy, it is possible not only to cure the disease, but also to rid the patient of the individual hypersensitivity of the body. To choose the right drug, it is necessary to consult with a specialist in this field.

• Brionia alba is a drug used for joint inflammatory processes with limited range of motion.
• Colchicum is a drug that helps restore appetite, relieve joint swelling, flatulence, stabilize the composition and characteristics of urine, calm and eliminate irritability.
• Formic acid is a drug used for joint pain caused by urates and protein in the urine. Eliminates pain, normalizes blood pressure.
• Celandine – added to water during bathing, helps relieve joint pain.
• Lithium carbide – improves the patient’s condition in the presence of uric acid in the joint cavities.
• Potassium carbonate is a drug that eliminates the negative impact of errors in the patient’s diet.

Experts say that the earlier treatment of the disease is started, the more favorable the outcome.

Traditional treatment of neuro-arthritic diathesis

Herbal treatment against the background of a diet and a regulated lifestyle of the patient creates favorable conditions for the restoration of disturbed metabolic processes.

For neuro-arthritic diathesis, lingonberry infusion is successfully used: 20 g of lingonberry leaves - 200 ml of boiling water, leave for half an hour, filter, drink 1 tbsp. up to 4 times a day.

During attacks of the disease, herbal remedies with anti-inflammatory, analgesic and diuretic properties are used. Such plants include:

• blue cornflower flowers;
• calendula;
• peony;
• juniper berries;
• buckthorn (bark);
• elderberry blossom;
• nettle leaf;
• horsetail;
• birch leaves.

They stabilize metabolic processes and help remove uric acid from the body:

• St. John's wort;
• chamomile;
• linden blossom;
• elderberry blossom.

Baths with a decoction of succession, chamomile flowers, and lovage give a good effect.

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Diet for neuro-arthritic diathesis

When you are ill, it is advisable to eat on a schedule, at the same time, avoiding periods of fasting and overeating. The menu should consist of the following products:

• dark flour products;
• dairy products;
• vegetables;
• cereals (oatmeal, pearl barley, buckwheat, millet);
• fruits;
• eggs (1 pc. per day).

You will have to limit your consumption of the following foods:

• mushrooms;
• animal fats;
• sweets;
• meat in any form;
• fish in any form;
• sugar;
• nuts.

The following products are subject to absolute exclusion:

• coffee, cocoa, chocolate;
• offal;
• canned goods, pates;
• herring;
• broths based on meat or fish;
• carbonated sweet water;
• legumes (peas, beans).

It is also better to exclude greens, sorrel, and cauliflower.

The main goal of the diet is to restore the acid-base balance in the patient’s body.

The diet must be combined with a drinking regime. This means fairly frequent consumption of alkaline liquids - mineral water, tea with lemon, fresh fruit juices.

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Prevention of neuro-arthritic diathesis

Preventive measures consist of prescribing and following a certain daily routine and meal plan. It is important to control mental stress, isolate the patient from stress, fears and negative emotions.

Moderate physical exercise, hardening, special nutrition that does not allow purines to enter the body, limiting the formation of ketone bodies and urea are welcomed. The patient is recommended to spend more time in the fresh air, periodically undergo massage and manual therapy sessions.

How to prevent disease crises? If the patient's condition worsens, strict bed rest, strict adherence to a diet, and a course of hyposensitizing therapy are required. It is necessary to periodically take multivitamin and mineral complexes prescribed by a doctor. Particular attention should be paid to personal hygiene - care of the skin and mucous membranes.

Patients should not be allowed to follow fasting and protein diets, and the amount of fluid should not be limited.

The prognosis of the disease is determined by such factors as early detection of metabolic disorders, timely treatment, and the patient's adherence to a diet and daily routine.

Many medical specialists note that neuroarthritic diathesis is not a diagnosis, but a predisposition of the body to metabolic disorders and diseases of the urinary system. Therefore, if you start treatment on time and strictly follow the doctor's recommendations, you can avoid the negative consequences of the pathology.