Vasculitis in Children
Children with vasculitis need ongoing management by a team of specialists. Early identification of the autoimmune disease and effective treatment are key to minimizing damage to vital organs, including the kidneys, heart, and lungs. Duke pediatric rheumatologists work with specialists to put your child's disease into remission and prevent or treat the organ damage that can result.
Experience is Key to Identifying Vasculitis in Children
Vasculitis causes inflammation of blood vessels that may impact the flow of blood to organs. Its vague symptoms -- fatigue, skin rashes, low fever and other common childhood complaints -- makes it hard to diagnose. Its effects can be severe. Heart, lung, and kidney damage are serious concerns.
Duke pediatric rheumatologists are experienced at differentiating vasculitis from medical conditions with similar symptoms. We treat children with a wide range of inflammatory blood vessel disorders, including Henoch-Schonlein purpura, Kawasaki disease, Takayasu arteritis, and ANCA-associated vasculitis (including microscopic polyangiitis and granulamatosis with polyangiitis).
While vasculitis is a lifelong condition, it can be controlled through ongoing management. As your child grows, we help transition their care to an adult rheumatologist.
VASCULITIS IN CHILDREN
Medication is the primary treatment for vasculitis. Your child may need one or more drugs to prevent inflammation, control their body's immune response, relieve symptoms, or treat complications.
Steroids like prednisone can suppress the entire immune system. They may be prescribed to quickly reduce inflammation. They require careful monitoring to avoid long-term side effects
These medicines, including mexothrexate and CellCept, are sometimes called steroid-sparing drugs. They offer many of the benefits of corticosteroids with fewer side effects but can take longer to work. Over time they help slow or stop the progression of vasculitis.
This newer class of disease-modifying drugs is made from living organisms. Instead of suppressing the entire immune system, they target specific parts of it. Certain biologics, including rituximab or tocilizumab, are increasingly being used to treat vasculitis.
Certain types of vasculitis, including Kawasaki disease, respond well to IVIg, a blood product that contains antibodies from many healthy donors.
Surgery is rare but may be necessary if certain complications are present.
VASCULITIS IN CHILDREN
An accurate diagnosis is the first step toward prompt, effective treatment. A physical exam and the following tests may be performed to rule out other illnesses, determine which blood vessels are affected, and assess whether certain organs have been impacted or are at risk. If these tests identify the potential for damage to vital organs or other medical concerns, we work with specialists throughout Duke to coordinate your child's care. As a result, your child's team may include pediatric cardiologists, dermatologists, pulmonologists, and kidney disease specialists when necessary.
Help detect the presence of inflammation and organ damage.
CT, MRI, or angiogram can rule out tumors, infections, and other medical concerns. They also show whether vasculitis is harming specific blood vessels or organs.
A small sample of tissue is removed, allowing a closer look at the cells that may be causing the inflammation.