Rheumatology Conditions and Treatments
The following links from the American College of Rheumatology provide basic information on the topics listed below. Patients with rheumatic diseases can find a For a complete list of rhematology resources and disease information visit:
Juvenile Idiopathic Arthritis
Juvenile idiopathic arthritis—commonly called JIA—may involve one or many joints, and cause other symptoms such as fevers, rash and/or eye inflammation.
Systemic Lupus Erythematosis
Systemic lupus erythematosus (SLE or lupus) is a disease in which the immune system is overactive and does not function properly. The immune system attacks the body and creates inflammation in the skin, joints, kidneys, lungs, nervous system, and other organs of the body. People with lupus can have times of very active disease, called a flare, and times where the disease is mostly quiet, called remission.
Juvenile dermatomyositis is an inflammatory disease of the muscle (myositis), skin and blood vessels that affects about 3 in 1 million children each year. The cause is unknown. The symptoms of JDM include muscle weakness and skin rash.
Antiphospholipid antibody syndrome (commonly called antiphospholipid syndrome or APS) is a recently identified autoimmune disease present mostly in young women. Those with APS make abnormal proteins called antiphospholipid autoantibodies in the blood. This causes blood to flow improperly and can lead to dangerous clotting in arteries and veins, problems for a developing fetus and pregnancy miscarriage. People with this disorder may otherwise be healthy, or they also may suffer from an underlying disease, most frequently systemic lupus erythematosus (commonly called SLE).
Localized Scleroderma (Juvenile)
Scleroderma means “hard skin.” Children with localized scleroderma, often have involvement of the tissues below the skin, including muscle and bone. Besides the skin hardening, there can be changes in skin color and texture, and the underlying tissues may fail to grow normally. Localized scleroderma can occur in several different forms, including linear scleroderma (where the lesion appears as a line or streak) and circumscribed morphea (where the lesion appears as a roundish lesion). Most patients have the disease on just one part or side of their body. Early on, some lesions may have a red or purplish color that may be limited to the lesion border. Others may have a white or waxy appearance and feel hard.
Hyperimmunoglobulin D Syndrome or Mevalonate Kinase-Associated Periodic Fever Syndrome
Hyperimmunoglobulin D Syndrome (HIDS) is a genetic syndrome that results in episodes of high fever with skin rash, swollen lymph nodes in the neck, mouth sores, abdominal pain, joint pain and swelling, vomiting and diarrhea. Most patients have high amounts of proteins called immunoglobulins (especially D), which normally are used by the immune system to fight infections. The most severe form of this disease starts at birth and is called mevalonic aciduria. These patients also have severe neurologic (nervous system) disease and poor growth.
Fevers are the main symptom, usually lasting 3-7 days, and may recur every 2-12 weeks. The episodes begin suddenly, often with shaking chills. Headache, abdominal pain, loss of appetite and flu-like symptoms are common. Most patients experience nausea, vomiting or diarrhea. Skin rashes on all parts of the body—Including the hands and feet, painful sores in the mouth and joint pain—may occur. One of the most striking features is swelling of the lymph nodes in the neck or other parts of the body. Patients may develop joint and muscle pain as well as joint swelling in small and large joints.
Joints that are more flexible or move in excess of normal range of motion are considered hypermobile. When generalized hypermobility occurs with muscle or joint pain without systemic disease, it is called benign joint hypermobility syndrome or joint hypermobility syndrome. Rarely, children may have a more widespread connective tissue disorder associated with their hypermobility such as Marfan or Ehlers-Danlos syndrome.
Cryopyrin-Associated Autoinflammatory Syndromes (CAPS) (Juvenile)
Cryopyrin-associated autoinflammatory syndrome (CAPS) includes three diseases related to a defect in the same gene. The three diseases differ in the organs involved and in the severity of the disease.
- Neonatal Onset Multisystem Inflammatory Disease (NOMID), also called Chronic Inflammatory Neurological Cutaneous Articular Syndrome (CINCA) in Europe
- Muckle-Wells Syndrome
- Familial Cold Autoinflammatory Syndrome
NOMID is the most severe of the CAPS and causes fever with inflammation in multiple organs. Newborn babies can have signs of infection (e.g., fever, rash) but no infection is found. The rash resembles hives, but is not itchy. Patients can have chronic meningitis (inflammation of the membranes surrounding the brain) resulting in headache, blindness, or hearing loss and other neurologic problems. The eyes often appear as bulging, and children often have episodes of vomiting. After 1 year of age, 50 percent of patients develop joint pain and swelling. There can be growth delay; children with NOMID are often very short. Not all children have all of these symptoms.
In Muckle-Wells syndrome, patients develop episodic fever, rash, red eyes, joint pain and severe headaches with vomiting. Episodes last from 1-3 days. Deafness or partial hearing loss often develops by teenage years.
In familial cold autoinflammatory syndrome, exposure to cold (including air-conditioning) and—perhaps—other environmental triggers causes a hive-like rash. Patients also can develop fever, chills, nausea, severe thirst, headaches and joint pain. Episodes usually last up to 1 day.
- Abatacept (Orencia)
- Anakinra (Kineret)
- Azathioprine (Imuran)
- Cyclophosphamide (Cytoxan)
- Cyclosporine (Neoral, Sandimmune, Gengraf)
- Gold (Myochrysine, Ridaura, Solganol)
- Hydroxychloroquine (Plaquenil)
- Leflunomide (Arava)
- Methotrexate (Rheumatrex, Trexall)
- Minocycline (Minocin)
- Mycophenolate Mofetil and Mycophenolate Sodium (Cellcept and Myfortic)
- Rituximab (Rituxan and MabThera)
- Sulfasalazine (Azulfidine)
- Tocilizumab (Actemra)
Rheumatology Conditions and Treatments