The Hidden Story Behind Juvenile MTX
Once upon a time, while enjoying a delicious dinner with my family, I (the owner of this site) noticed my youngest sister struggling to stand up from a ground-sitting position when trying to go the toilet to get her hands washed. She is eight and she never complained of any pain before. When she got out of the toilet, I followed her and talked to her in private in her bedroom. I asked her about how and why she wasn't able to stand up as smooth as any kid at her age would, she replied: I don't know, this is just me!
At this moment I knew there was something wrong with her, and I immediately remembered few months back when we took her to the usual park she always loved to go, we noticed that she is tripping over her own foot multiple times while running and playing! She also gets tired too soon after walking for short period and she asks to sit down very often, we thought she is just tired and not in mood of playing or running around that day.
Combining these two incidents together, we decided to get her a visit to one of the most well-known pediatrician in the region. After a detailed history and physical examination, the pediatrician concluded that she is suffering from muscle weakness affecting mostly her thighs and shoulders. Based on this, the doctor requested many lab investigations and imaging to reach a definite diagnosis. One week later we visited the doctor again to have a look at the final results. The pediatrician diagnosed my sister with a disease called Juvenile Dermatomyositis.
Its basically an inflammation of muscle and skin, where the immune system attacks some muscle parts of the body, and also attacks the skin causing several serious skin lesions specially when exposed to the sun without proper sunscreen blockers. Treatment is available but the outcome is doubtful, and it all depends on when and how soon you start the treatment after the onset of symptoms.
She was started on steroid therapy, and another chemotherapy drug called MTX. This is the best combination of treatment to be started for this disease as per the recent literature.
I won't lie, she showed dramatic response to these medications during the first six weeks of therapy. She was able to walk for longer periods of times, she was able to stand up easily without any hassle. On the other hand, she was suffering a lot of side effects caused by these medications, specially the steroid. Abdominal pain, headache, joint pain, and falling hair, were debilitating. The sudden increase in her body weight exerted significant pressure on her lower back resulting in a very severe back pain that made her immobile.
With all the aforementioned side effects, she was still able to get along well. Part of her management was limb physiotherapy to strengthen her muscles, which she was doing at home regularly. At week eight of therapy, she started having excruciating muscle spasm of the back. Do you remember how it feels when you get calf muscle spasm during an exhausting football match? That's exactly what she was facing but not her calf muscles, it was her back muscles instead!
I remember when she used to get this muscle spams attack in front of me, the pain was so severe to the extent that she was screaming and her back was twisting and curling to the right and left. We took her to the hospital and admitted her for three weeks. After extensive research and investigations, the medical team found out that MTX was the cause of these muscle spasms of the back. Once we stopped the MTX, the muscle spasms didn't reoccur.
You may wonder and ask, why they (the medical team) haven't though of MTX as the cause of these muscle spasm from the very beginning and why it took three weeks to reach this conclusion. The short answer is that MTX is not known for this side effect.
During these three weeks of hospital stay, I strengthened and reinforced the bond between me and her, and she told me once that she wishes to work in a jewellery shop as she always had interest in earrings and necklaces. She has a good taste in beauty and fashion.
Few months later, me and her visited one of the major jewellery manufacturer in the region, and made a special contract with them. We gave them special instructions and information regarding the specifications and designs of the jewellery we wish to sell. And Here in our website we are presenting to you these special collections.
Now she is being treated with a different drug called Intravenous Immunoglobulin and a low dose of steroid and she is doing well.