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 – 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. Since the COVID-19 Pandemic, a child rheumatologist also has a role in treating inflammation called MIS-C. Other indications would be an abnormal ANA result or high inflammatory markers (ESR/CRP) without a definitive diagnosis.
Diseases Paediatric Rheumatologists look after – Children with Biomechanical joint pain 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, the 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.