Symptoms – Child having prolonged or recurrent fever and is being extensively investigated without a diagnosis? Symptoms such as joint pains or swelling, rashes, mouth ulcers, genital ulcers, blue fingers/toes, excessive hair loss, red eyes, blood in stools or muscle weakness? These may be symptoms of a child with a chronic autoimmune rheumatological illness which, if identified and treated early, can be managed better by a doctor qualified and experienced in managing such children.
Since the COVID-19 Pandemic, a child Rheumatologist also has a major role in identifying and treating MIS-C (Multisystem inflammatory syndrome in Children). MIS-C can present with fever, rashes, red eyes, red tongue, acute abdomen pain, hypotension and heart involvement (coronary dilatation, myocarditis, wall motion abnormalities on a heart scan).
Diseases Pediatric Rheumatologists look after – Children with joint swelling – Juvenile arthritis (JIA) including Systemic JIA, SLE (Systemic Lupus Erythematosus), Childhood vasculitis such as IgA vasculitis (HSP), Kawasaki disease, Takayasu arteritis, Polyarteritis nodosa, ANCA vasculitis, Connective tissue diseases such as Juvenile Dermatomyositis (JDM) MCTD & Overlap syndromes and scleroderma, Bone Inflammation (CRMO), Pyrexia of unknown origin (PUO), Autoinflammatory diseases with recurrent fevers and children with biomechanics /non-inflammatory joint pains.
Acute emergencies – Even though most of these diseases are chronic conditions with the long-term sequel, there are some which can also present with acute emergencies such as MAS (Macrophage Activation Syndrome) secondary to Systemic JIA, Kawasaki disease or Lupus. Some vasculitis (inflammation in the vessels) can present with severe bleeding from the lungs and can be fatal. MIS-C as mentioned earlier can also be life-threatening if not identified on time.
A timely referral is key for the diagnosis and management of autoimmune diseases.