Gore two-year-old's painful rash diagnosed as rare arthritis

Two-Year-old Madilyn Paish was diagnosed with systemic juvenile idiopathic arthritis in December. Photo / Supplied
Two-Year-old Madilyn Paish was diagnosed with systemic juvenile idiopathic arthritis in December. Photo / Supplied
Two-year-old Madilyn Paish's joints are so stiff in the morning she can barely walk and some days her skin is so sore she can hardly stand to wear clothes.

The Southland toddler is living with a rare form of arthritis - a condition most people associate with old age.

Mum Makayla Milne first took Madi to a doctor when she became unwell and developed a painful rash at five months of age.

That was the first of many trips to the doctor or hospital at which she was told it was a virus or teething.

But Milne knew there was something more going on.

The rash was so painful Madi was constantly screaming in pain and telling her mum her "skin was ouch". Her joints also swelled up regularly.

It became so bad that in December, more than a year after the rash first appeared, she called an ambulance and demanded they take her from their home in Gore to Southland Hospital where a paediatrician confirmed her fears.

He agreed straight away there was something more serious going on and after a week of testing she was diagnosed with systemic juvenile idiopathic arthritis.

About one in 1000 children have juvenile idiopathic arthritis - inflammation of the joints in which a cause cannot be identified.

Only about one in 10 of those children have the systemic version which often involves fevers, rashes and inflammation of organs as well as joint swelling, stiffness and pain.

The disease can lead to heart and lung problems, interfere with normal growth and bone development and cause high blood pressure.

There is no cure for the disease but with the right treatment remission is possible, leaving the child with little to no symptoms.

Milne said the diagnosis left her in tears.

"I was so overwhelmed. I was so happy that she had a diagnosis but I was so mad and upset at the world that she was so sick and I was mad at myself that I was happy that she had a diagnosis because it was such a bad diagnosis."

The tests also revealed she had a heart murmur and was severely anaemic.

Madi was quickly started on steroids in an effort to help with the pain and swelling but the toddler developer "roid rage" which is now controlled by adding another medication.

In February, doctors started Madi on a weekly dose of the chemotherapy drug methotrexate which is used in low doses as an anti-rheumatic drug.

Milne said injecting the drug into her little girl every week was the hardest thing she's ever had to do.

And despite the low dose, the drug still made Madi feel miserable and put her off food for a few days.

Since then doctors have discovered Madi's body is no longer making the natural steroids and adrenaline it needs and her kidneys are starting to be affected.

While she no longer gets rashes, her skin and joints are still painful so last month she was started on a second chemotherapy drug which she will get a dose of every two weeks for the next six months.

Despite it all, Madi remained a fun, sassy toddler, Milne said.

"Some days are harder than others. Some days she cries but most days she's full of sass and you wouldn't know she's sick. She's the funniest, most caring little girl ever."

Arthritis New Zealand awareness and advocacy manager Francesca Holloway said the impact of juvenile idiopathic arthritis could be significant because most people were not aware it could affect children.

"Children and teens who attend the camps that Arthritis New Zealand run talk about challenges they face at school including bullying and disbelief that children can have arthritis. One child reported that peers at school thought he was making it up about having arthritis," she said.

But a close friend, who had become Madi's honorary nana, has set up a Givealittle page for the family to make life that little bit easier by helping them cover the cost of weekly trips to Southland Hospital and other expenses.

At the top of the list are a new mattress to try to help Madi sleep more comfortably and reduce the stiffness and pain in the morning and a safer car to make the two-hour round trip to hospital each week.

If Madi went into remission, any donations not used would be donated to the children's ward at the hospital, Milne said.

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