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There's no single set of symptoms that covers the spectrum of autoimmune disease. The most common symptoms tend to be nonspecific, meaning they could be caused by a condition that has nothing to do with the immune system. This can make it harder for doctors to diagnose autoimmune diseases. As a result, a child may need a number of tests to narrow down the possible cause for their symptoms. Signs that a child may be having an immune system problem include: Recurring fever, fatigue, rashes, weight loss and so on are not concrete proof that a child has an autoimmune disease, but they do mean the child is ill and needs medical attention. A pediatrician can refer the family to a specialist, likely a pediatric rheumatologist, if they suspect an autoimmune disease. The exact reason that some children's immune systems begin attacking their own bodies is still a mystery. We do know that autoimmune diseases are not contagious, and they don't appear to be caused by any one thing in particular. Instead, scientists believe there's a multi-step process at work: Researchers are now working to discover which genes are involved and how they interact. They are also investigating a number of potential environmental and hormonal triggers so that one day it may be possible to cure, or even prevent, autoimmune diseases.
Autoimmune diseases present a special challenge for physicians. Many of the earliest symptoms like fever and fatigue are nonspecific, meaning they're found in a variety of illnesses. Symptoms often come and go. A single autoimmune disease can show up in different ways in different people or include features of other autoimmune diseases. For reasons like these, diagnosis can be a long and stressful journey for many families. It's important to remember that such difficulties are not a sign there's something uniquely wrong with your child. Even when doctors aren't 100 percent sure which specific autoimmune illness a child has, they often can learn enough from the diagnostic process to begin treatments to improve their health and quality of life. A rheumatologist will first look at your child's full health history including any family history of autoimmune disease — and conduct a thorough physical exam. If the doctor suspects a autoimmune disease, they will gather more information through lab tests, including: The doctor may also want to take a closer look at your child’s actual organs and tissues to rule out things like infections, tumors and fractures. To do this, the doctor might use such imaging tests as: In some cases, your child's doctor will actually take a sample of your child’s tissues — called a biopsy — to help identify the disease or to get an idea of how it’s progressing. Overall, today's diagnostic tools can help physicians home in on autoimmune disease, but can’t do much to differentiate one illness from another. To solve that problem, many researchers are now working on identifying biomarkers things that the body is doing or making that point to a specific illness — for autoimmune diseases. Such biomarkers could allow doctors to make faster, more accurate diagnoses and get started on treatment that much sooner. Rheumatologists, who specialize in diseases of the joints and connective tissue, often diagnose autoimmune illnesses and tend to be at the center of the health care team. Depending on which tissues or organs are affected, other specialists such as a dermatologist (skin), hepatologist (liver) and nephrologist (kidneys) — may be involved in caring for your child. While there's no cure for the vast majority of autoimmune diseases, doctors aim to do far more than just manage your child's symptoms. They will work to immediately relieve things like soreness and stiffness, and restore important substances to your child's body that the disease may be taking away (like insulin, in type 1 diabetes). But the big goals are to quench the inflammation of the autoimmune reaction to keep it from doing further damage and to & reset the immune system so that it will work normally on its own. Broadly speaking, doctors prescribe medications that 1) fight the harmful inflammation caused by autoimmune attack and 2) suppress the overall immune system or block specific things that it's doing. Surgical therapies for autoimmune diseases are very rare. Doctors often favor aggressive upfront treatment with an array of drugs (some of which have significant side effects, which your child's doctor will discuss with you in detail). Therapies commonly prescribed for autoimmune disease include:
Depending on your child's autoimmune disease, they may need other kinds of medical treatment, such as:
Though essential, medication is just one part of your child's treatment program. Most kids with autoimmune diseases also require physical and occupational therapy, to increase their mobility and muscle strength and to learn ways to make day-to-day activities easier on their bodies. And because chronic illnesses like these can be mentally and emotionally tough to deal with, psychotherapy or counseling can be valuable in helping kids keep the positive outlook they need to "beat" their disease. What is the long-term outlook for a child with an autoimmune disease?By and large, autoimmune diseases are considered lifelong conditions. Certain illnesses, like juvenile dermatomyositis, can be “cured,” in the sense that with successful treatment, the symptoms never recur. Many kids grow out of other illnesses, like certain types of juvenile idiopathic arthritis. But even when a child’s autoimmune disease “goes away” (this is called remission), they’ll always need to keep a close eye on their health because the immune system has already shown it’s capable of attacking healthy tissue. If a child has a more serious autoimmune disease, they may go through periods of getting better (remission) and getting worse (relapse). A sudden, severe return of symptoms, called a flare-up, isn’t uncommon. Both medical treatment and lifestyle changes can go a long way toward bringing these shifts under control. Even after diagnosing a child’s particular autoimmune disease, doctors can’t predict exactly what will happen. But they can give families a general sense of what the future holds and develop a treatment plan that ensures the best possible outcome. In some cases, severe autoimmune diseases — especially those affecting the liver, kidneys, lungs, blood vessels and other vital organs — can be life threatening. Fortunately, though, these illnesses are very rare. Treatment aims to keep these vital organs healthy. Infection is another potentially life-threatening problem for certain children; however, with appropriate monitoring and treatment, families and doctors can work together to minimize such risks. |