Autoimmune diseases in children – Role of a Pediatric Rheumatologist

You must have heard of a specialist doctor called a Rheumatologist looking after someone with arthritis in your family. Have you ever heard of a Children’s Rheumatologist? Do you know that an estimated 1 in every 1000 children can develop disabling childhood arthritis starting as early as 1 year of age and can lead to deformed joints for life if not identified and treated early? Childhood autoimmune diseases are being recognized more than ever before and we all need to be aware of the symptoms of such diseases in children.

Symptoms of autoimmune rheumatological illnesses

-Joint pains and arthritis in children

-Prolonged or recurrent fever without a diagnosis

-Rashes, mouth ulcers, genital ulcers, blue fingers/toes, hair loss, red eyes, joint pains or swelling or muscle weakness

– An abnormal ANA or RF result or high inflammatory markers (ESR/CRP) without a definitive diagnosis

Diseases Pediatric Rheumatologists look after

Children with Biomechanical joint pains and Juvenile arthritis (JIA), Connective tissue diseases like SLE (Lupus), Juvenile Dermatomyositis (JDM), Scleroderma, etc. Childhood Vasculitis such as Kawasaki Disease, HSP, PAN and Takayasu Arteritis, etc., Bone Inflammation (CRMO), Pyrexia of unknown origin, and Autoinflammatory diseases with recurrent fevers.

Medications and the need for an early referral

Steroids should be used cautiously in view of long-term side effects. Science has progressed immensely in the last 10 years and we now have newer medications called biologics with minimal side effects that halt the inflammatory process rapidly. With the advent of biosimilars, affordability has been much better in recent years and is expected to improve over the coming years. Early referral is a must so that timely treatment of these conditions can be done.  

Dr. Abhay Shivpuri

Consultant Pediatric Rheumatologist, Jaipur

MBBS, DNB Pediatrics

Post doctoral Fellowship in Pediatric Rheumatology (SGRH, New Delhi, India)

RCPCH Fellowship in Pediatric Rheumatology (GOSH, London UK)

Former Consultant Pediatric Rheumatologist (SCH, Sheffield UK)

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