Pediatric Rheumatology Conditions & Treatments

Conditions We Treat

More than 600 diseases fall under the umbrella of rheumatology. These inflammatory and autoimmune disorders can affect the bones, joints, tendons, skin, internal organs and other parts of the body. Some of the most common conditions we treat include:

• Autoinflammatory syndromes: A group of rare diseases in which the body has difficulty turning off inflammatory response. Examples of this include PFAPA, Behcet’s disease and Blau syndrome (juvenile sarcoidosis).
• Chronic recurrent multifocal osteomyelitis (CRMO): A rare autoimmune disorder that causes inflammation of the bones.
• Hypermobility syndrome: Unusual flexibility of the joints (loose- or double-jointed) can sometimes cause pain or lead to higher risk of sprains, dislocations or secondary arthritis.
• Immune dysregulation: A dysregulated immune condition occurs when the body can't control its immune response, either over-reacting and attacking healthy tissues or underreacting and allowing infections to spread.
• Juvenile idiopathic arthritis: The most common type of arthritis in children, juvenile idiopathic arthritis can cause inflammation that may have a lasting effect on their growing bones and joints.
• Juvenile dermatomyositis: A rare autoimmune disorder that causes skin rash and muscle inflammation.
• Kawasaki disease: A rare disease that most commonly affects children under age 5, Kawasaki disease is a type of blood vessel inflammation that can affect the whole body, including the blood vessels of the heart.
• Macrophage activation syndrome (MAS): A rare but potentially life-threatening complication of systemic juvenile idiopathic arthritis in which an inflammatory response overwhelms the body.
• Mixed connective tissue disease: This disease occurs when children have mixed or overlapping symptoms from several different autoimmune disease, such as lupus, scleroderma and myositis.
• Scleroderma: A rare, chronic disease that causes abnormal connective tissue growth, affecting the joints, skin and other organs.
• Serum sickness: A syndrome that causes an allergy-like immune response and can cause skin rashes, joint stiffness, joint pain, facial and extremity inflammation, and fever.
• Spondyloarthropathy: A type of arthritis that affects the spine and nearby joints, causing pain in the spine, shoulder and hips.
• Systemic lupus erythematosus: Also known simply as lupus, this is a chronic autoimmune disorder in which the body’s immune system attacks its own cells and tissues. The disease is unpredictable since it affects everyone differently and symptoms range from mild to severe.
• Sjogren’s syndrome: An immune disorder characterized by dry skin, eyes and mouth. It often accompanies other rheumatic conditions such as lupus.
• Uveitis: Inflammation of the eye usually caused by an immune response.
• Vasculitides (Vasculitis): A disorder that causes inflammation of the blood vessels.

Consultative services to primary care physicians are also available for non-inflammatory conditions such as:

• Amplified musculoskeletal pain syndromes (AMPS): An umbrella term for non-inflammatory pain disorders that can cause intense recurring or continuous musculoskeletal pain anywhere in the body.
• Fibromyalgia: A chronic condition that causes muscle and soft-tissue pain throughout the body. It can affect the neck, shoulders, back, hips, arms, legs and other areas.
• Patellofemoral syndrome: Also known as runner’s knee, this condition can cause chronic pain in the front of the knee, or kneecap.
• PFAPA (periodic fever, phthous stomatitis, pharyngitis, adenitis): The most common of a group of disorders called periodic fever syndromes, PFAPA causes symptoms such as reoccurring fevers, swollen lymph nodes, mouth sores and sore throat.

Diagnosis and Treatment of Rheumatic Conditions

When a patient is referred to UH Rainbow arthritis and rheumatology services, we will begin with a physical exam, medical history and ordering various tests. These may include:

• Blood and urine lab tests
• Genetic testing
• Imaging such as X-rays and magnetic resonance imaging (MRI)

Specific treatments will vary depending on the diagnosis, but some of the recommended therapies may include:

• Anti-inflammatory medications such as steroids
• Immunosuppressants
• Infusion therapy
• Subcutaneous (SubQ) injections
• Integrative therapies
• Physical/occupational therapy

Patients who require infusion services will have access to our dedicated pediatric infusion center, located on the eighth floor of UH Rainbow Babies & Children’s Hospital.

Mental Health Support

Patients may also be referred to our dedicated pediatric clinical psychologist. Pediatric rheumatology patients have more need for mental health support due to anxiety, depression and other mood disorders. Patients comply more completely with medication regimens when they are supported with mental health services.

Inborn Errors of Immunity Clinic

Inborn errors of immunity (IEI) are disorders in which the immune system does not function properly as a result of a genetic defect. The Inborn Errors of Immunity Clinic at UH Rainbow brings together specialists in pediatric allergy/immunology, rheumatology, gastroenterology, dermatology and other pediatric specialties to provide comprehensive care for children with IEI, helping to manage their symptoms and improve quality of life.