Pediatric Rheumatology - An Overveiw

Introduction

Autoimmune diseases are malfunctions of the body's immune system, causing the body to attack its own tissues. It is usually unknown why something and not others causes an autoimmune reaction or disorder. However, genetics may also play a role. Some people carry genes that make them slightly more likely to develop an autoimmune disease. This slightly increased susceptibility to autoimmune disease is inherited rather than the disease itself. Triggers such as viral infections and tissue damage can trigger the development of the disease.

What Does a Pediatric Rheumatologist Do?

A pediatric rheumatologist is a doctor with specialized training in the treatment and diagnosis of autoimmune diseases that affect children. The most common reasons children are referred to a pediatric rheumatologist include swollen and stiff joints, persistent unexplained fever, rash, weakness, and chronic inflammation.

What Conditions Are Treated by a Pediatric Rheumatologists?

A pediatric rheumatologist works along with a pediatrician to evaluate and treat a variety of conditions, including:

• Acute Arthritis - Joint inflammation.

• Chronic Arthritis - It includes juvenile arthritis of unknown origin.

• Autoimmune Conditions - Lupus and related diseases such as Sjögren's syndrome, scleroderma, mixed connective tissue disease.

• Muscle Inflammation - Dermatomyositis and other forms of muscle inflammation.

• Blood Vessel inflammation - Vasculitis with inflammation of blood vessels.

• Autoinflammatory Syndromes - PFAPA (periodic fever, aphthous stomatitis, pharyngitis, adenitis) and other periodic fever syndromes.

• Chronic Uveitis - Eye inflammation.

What Type of Tests Does Pediatric Rheumatologist Conduct for Diagnosis?

At the first visit, the pediatric rheumatologist will record a complete history of the child's symptoms along with family history. The doctor will also review recent lab values ​​and images and perform a complete physical examination. Sometimes, a diagnosis cannot be made at the first visit and multiple follow-up visits are required. In addition to taking the history and clinical examination, the pediatric rheumatologist may recommend some of the following tests during the examination:

• Laboratory Tests - These include blood and urine tests.

• Imaging Tests - These tests include X-ray, magnetic resonance imaging (MRI), and ultrasound.

• Respiratory Function Test - The functioning of the lungs is checked by this test.

• Skin or Muscle Biopsy - A sample of the skin or muscle is taken in this method to scrutinize under the microscope.

• Nerve Examination - Nerve conduction studies are done to examine the electrical activity of nerves.

• Fluid Removal From the Joints - Joint suction is done to remove fluid from around the joint, such as the knee.

Why Does Someone Need to See a Pediatric Rheumatologist?

Children are not just small adults. Their bodies are growing and have their own medical needs. They express their concerns in a different way than adults. They are not always able to answer medical questions and are not always patient and cooperative. A pediatric rheumatologist knows how to see children and understands how to gain their trust and cooperation in order to achieve their best developmental potential. If the pediatrician recommends that the child see a pediatric rheumatologist, an individual can be confident that their child is receiving the best possible care. A pediatric rheumatologist may include other subspecialists (pediatric ophthalmologists, orthopedic surgeons, dermatologists, nephrologists, etc.) and rehabilitation specialists (physiotherapists, occupational therapists, expression therapists, etc.), social workers, and psychologists, and They may work in cooperation with nutritionists and prosthetists.

What Diseases Does a Pediatric Rheumatologist Usually Treat?

The autoimmune diseases in children a pediatric rheumatologist usually treats are listed below:

• Juvenile Idiopathic Arthritis - Persistent joint pain, swelling, and stiffness of unknown origin in children.

• Raynaud's Phenomenon - Narrow and constricted arteries that supply to the skin leading to blue skin in cold and stress.

• Juvenile Dermatomyositis - Inflammation of muscles due to autoimmunity.

• Lupus - Autoimmune condition that attacks the body’s organs and a wide range of tissues.

• Localized Scleroderma - Inflammation of skin due to autoimmunity.

• Vasculitis - Inflammation of blood vessels due to autoimmunity.

• Kawasaki Disease - Inflammation of blood vessels of the heart due to autoimmunity.

• Familial Mediterranean Fever - Repeated fevers with pain in the abdomen, chest, or joints.

• Uveitis - Inflammation of the eye due to autoimmunity.

• Sjogren's Syndrome - Disorder due to autoimmunity characterized by dry eyes and mouth.

• Henoch-Schönlein Purpura - Inflammation and bleeding of small blood vessels of joints, brain, kidneys, and intestines.

When to See a Pediatric Rheumatologist?

An appointment with a pediatric rheumatologist should be sought immediately if the following signs and symptoms are noticed in a child. This should be done without delay to rule out any autoimmune disease in the child.

• Stiffness and Swelling - Stiffness and pain can vary, but most are persistent. Joint pain, swelling, and stiffness are usually worse in the morning, after a nap, or after a period of inactivity.

• Pain - The child may or may not complain of joint pain. The child may not be able to explain the pain or may be used to its presence.

• Hesitation in Using the Joint - People may find their child dragging their feet or trying to keep themselves from using certain joints. Also, the joint range of motion may be limited.

• Sleeping Disorder - The child may have trouble falling asleep or staying asleep.

• Fever - The child may have a persistent low-grade fever of unknown origin.

• Skin Irritation - A persistent skin rash of unknown origin may be present in the child.

• Skin Thickening and Tightening - The skin may seem thickened or thigh in certain areas of the body.

• Malaise - The child may hesitate or avoid activities in which they previously participated because they feel tired or in pain.

The child may have all or some of these symptoms, as rheumatic diseases affect every child differently. Some children may have symptoms for months, while others may have symptoms for several days. These symptoms vary from day to day and even on the same day. Symptoms may worsen or disappear for no apparent reason.

Conclusion

Pediatric rheumatology is a specialized field of medicine that deals with autoimmune conditions in children. These doctors are specially trained in dealing with children suffering from chronic illnesses.A pediatric rheumatologist is a doctor who specializes in providing comprehensive care to children (and their families) with rheumatic diseases, especially arthritis. Pediatric rheumatologists are specially trained to skills like different possible diagnoses in children, efficient use of tools and tests for diagnosis in children, selection of the most appropriate treatment for children with rheumatic diseases,multisystem diseases and managing children and their families with chronic illness.