It's not Just Growing Pains: A Guide to Childhood Muscle, Bone, and Joint Pain, Rheumatic Diseases, and the Latest Treatments

By Thomas J. A. Lehman | Go to book overview

6
Why Do Children Get
Rheumatic Disease?

One of the questions parents ask me as they come to grips with their child’s diagnosis of rheumatic disease is: “Why did this happen?” Medical research has made great strides over the past fifty years, but we still can’t really answer this question. It is frustrating to think that all of that time and effort has not given us the answers. The following paragraphs detail some of my own thoughts. Some of it is proven. Some of it is conjecture.

Most of the rheumatic diseases clearly occur with increased frequency in relatives of people with the diseases, not so much that a mother needs to be concerned that her child will have the disease, but enough that investigators have to notice. Fill a football stadium with 100,000 random children, and the rheumatic diseases are rare. Fill that same football stadium with 100,000 children who have relatives with rheumatic disease, and children with rheumatic disease would be ten or twenty times as common. So there must be a genetic contribution.

Since it is not good for your health to have rheumatic disease, why don’t genes that contribute to them go away over time? Imagine, if you will, a bank of ten switches that regulate the power to your town. Each switch provides 10 percent of maximum power. If all the switches are turned off, nothing works. One switch on helps, but two or three switches turned on are better. Everything works very well if five or six switches are turned on. However, maximum power is too much and things will start to overheat or short out if seven switches are turned on, especially if there is a thunderstorm. Eight switches on causes many more problems if it is too hot or too cold or there are storms. Things always go wrong if nine or ten switches are on. Now imagine if the number of switches that are turned

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