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Rheumatology Conditions & Treatments

We treat many children with pediatric arthritis as well as children with a wide range of common and rare rheumatic conditions. At Arkansas Children’s, our pediatric rheumatology doctors are experts in diagnosing and treating these conditions.

Our team provides the most advanced care and many of our doctors, nurses and staff are actively involved in research to improve care outcomes and find new treatments for these often difficult-to-manage conditions.

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis is a chronic disease with no known cause. There are different forms of the condition, which can affect one or more joints at a time and may also affect the skin and eyes. Juvenile idiopathic arthritis causes:

  • Joint inflammation
  • Swelling in the joints and/or the eyes
  • Pain
  • Limited movement
  • Skin rash
  • Fever

There is no cure for juvenile idiopathic arthritis. Treatments focus on reducing and controlling symptoms and allowing your child to live life as normally as possible. Treatments include:

  • Medicines to reduce inflammations, such as corticosteroids and anti-inflammatories. Medicines may be taken orally or given as joint injections.
  • Orthopedic surgery to replace joints if needed
  • Physical therapy and rehabilitation to keep joints flexible, and to strengthen bones and muscles to support joints. Therapy is also used after surgery to regain mobility.

Systemic Lupus Erythematosus (SLE)

Systemic lupus erythematosus is a rare, chronic autoimmune condition that can affect different parts of the body, such as:

  • Kidneys
  • Skin
  • Joints
  • Blood

Lupus is more common in teen girls and can be triggered by factors such as the hormonal imbalance of puberty. Other triggers include:

  • Environmental factors
  • Viral infections
  • Certain medicines

Lupus causes extreme fatigue, as well as other symptoms, such as:

  • Butterfly rash across nose and cheeks
  • Fever
  • Weight loss
  • Loss of appetite
  • Mouth sores

Treatment is used to reduce symptoms and make your child feel better. Options include:

  • Anti-inflammatory medicines such as steroids (prednisone)
  • Immunosuppressive medicines to calm an overactive immune system

Juvenile Dermatomyositis (JDM)

Juvenile dermatomyositis is an autoimmune condition most often diagnosed in children between the ages of 4 and 10. The disease leads to inflammation in tiny blood vessels in the muscles (myositis) and skin (dermatitis). The inflammation causes:

  • Muscle weakness
  • Pain, in muscles at the hip and shoulder
  • Skin eruptions:
    • In the face
    • Above the eyelids
    • On the knuckles
    • At knees and elbows

Treatments involved efforts to control inflammation and build more antibodies. The include:

  • Corticosteroids
  • Steroids
  • Intravenous Immunoglobulin
  • Physical Therapy

Uveitis

Uveitis is an inflammatory disease of the eye that can affect any part of the eye. The condition often occurs along with other rheumatic diseases, but what causes uveitis is often unknown. The swelling can destroy eye tissues. Symptoms include:

  • Decreased vision
  • Blurry vision
  • Pain
  • Light sensitivity
  • Increased floaters

In severe cases, blindness can occur. Treatments are used to control symptoms, prevent tissue damage and restore vision loss. They include:

  • Anti inflammatory eye
  • Immunosuppressive oral medicines

Overlap Syndrome

Overlap syndrome refers to patients diagnosed with an autoimmune rheumatic disease that cannot easily be identified as a known condition — such as lupus or juvenile arthritis — because symptoms and signs or more than one condition are present. To find the best treatments, our doctors will test your child for autoantibodies. They can match treatments to the specific genetic and biomarkers for your child’s condition.

Vasculitis

Vasculitis is the inflammation of blood vessels, causing poor blood flow to tissues (lungs, kidneys, skin) in the body. There are many forms of this rare condition, which vary widely in symptoms. The most common forms of vasculitis in children are:

  • Kawasaki disease
  • IgA Vasculitis (Henoch-Schönlein)

Symptoms include:

  • Shortness of breath
  • Cough
  • Numbness or weakness in a hand or foot
  • Red spots, lumps or sores on the skin

Treatments work to reduce inflammation and prevent damage. They include:

  • Steroids (prednisone)
  • Immune-suppressing drugs

In severe cases, surgery may be needed to:

  • Repair damaged blood vessels
  • Replace a damaged kidney with a transplant

Systemic Autoinflammatory Diseases (SAIDs)

Systemic autoinflammatory diseases are a new category of rheumatic and inflammatory conditions that differ from lupus and juvenile arthritis. SAIDs are inherited genetic conditions often involving fever syndromes. These are complex conditions that are difficult to diagnose because patients do not have blood markers, such as the autoantibodies used to identify certain diseases. Symptoms of SAIDs include:

  • Recurrent fevers
  • Rash
  • Chest and abdominal pain
  • Blood tests often show systemic inflammation when no infections are present

Treatment uses medicines to control the inflammatory episodes.

Periodic Fever Syndrome

Periodic Fever Syndrome refers to a group of autoimmune inflammatory conditions with similar symptoms. The main sign is a recurrent fever when there is no infection. Children with periodic fever syndrome usually feel well between episodes. The syndrome is often genetic. If doctors can find the mutation causing the disease in your child, specific treatments can be used.

The most common periodic fever is Familial Mediterranean Fever. Symptoms include:

  • Fever
  • Abdominal, chest and joint pain
  • Swelling

Treatments include medicines to control and stop the fever episodes.

Chronic Nonbacterial Osteomyelitis (CNO)

Chronic nonbacterial osteomyelitis is an autoimmune disorder that causes bone inflammation. What causes the condition is unknown, as no bacteria or infection are present when inflammation occurs. Symptoms include:

  • Bone pain
  • Swelling
  • Redness in the skin
  • Unexplained fevers
  • Bone lesions

Doctors find that treatment with immunosuppressive medicines yields better results than using anti-inflammatory medicines. Treatments include:

  • Anti-inflammatory medicines to reduce inflammation and pain
  • Immunosuppresive and biologic medicines to quiet the immune system
  • Corticosteroids to reduce inflammation