Pediatric Rheumatology

Questions discussed in this category

Is there a benefit to having a transition period in which a patient continues following with their previous pediatric rheumatologist while establishing care with a new adult rheumatologist?

What do adult rheumatologists need to understand about pediatric diseases?

3 Answers available

What are some of the biggest challenges you run into when patients transition from pediatric to adult care?

1 Answer available

Should the age at which patients transition from pediatric to adult care differ depending on the disease diagnosis?

What nuances do adult rheumatologists need to understand about pediatric diseases?

2 Answers available

Do you recommend adjusted adult cancer screening for patients who have been on long term biologics and/or tsDMARDs since childhood?

1 Answer available

What are some strategies to help teach patients transitioning from pediatric to adult care to become more independent with respect to their care and less dependent on their caregivers?

1 Answer available

How do you discuss sexual health with pediatric patients transitioning to adult rheumatology care when the patient is accompanied by parents or caregiver?

1 Answer available

How do you utilize cytokine panels in your clinical practice?

Is there utility when classic inflammatory markers (ESR,CRP) or disease specific markers (C3, C4, dsDNA) do not correlate with patients disease activi...

1 Answer available

What is your approach to evaluation and management of a patient with Blau Syndrome and GI manifestations?

2 Answers available

What do you recommend for fertility preservation in pediatric patients with impending cyclophosphamide use for treatment of a rheumatic disease?

3 Answers available

What additional immunomodulation would you consider in a patient with severe NXP-2+ JDM who has already received cyclophosphamide and rituximab but has persistent gastrointestinal vasculopathy?

1 Answer available

Do you recommend routine genetic screening (i.e., periodic fever panel) in a pediatric patient where you strongly suspect a periodic fever syndrome?

2 Answers available

Should testing for genetic causes of HLH be performed in all patients with MAS or secondary HLH regardless of the patient's age?

2 Answers available

How do you approach dosing of anakinra in MAS?

1 Answer available

How do you approach diagnosis and treatment of HLH/MAS following CAR T-cell therapy?

How is this entity distinct from other secondary HLH entities?

2 Answers available

What is your approach to treatment of infection-triggered HLH that does not respond to treatment of the underlying infection?

2 Answers available

In the setting of secondary HLH associated with initial diagnosis of lymphoma, would you adjust steroid dose and type to account for differences in HLH and lymphoma treatment protocols?

1 Answer available

What are the best labs to trend improvement in HLH?

1 Answer available

Are there any major differences in clinical manifestations or autoantibody profiles in children with SLE based on ethnicity?

2 Answers available

What are some explanations for the persistent renal outcome disparity gaps affecting certain minority groups of patients with pediatric SLE despite improvement in overall renal outcomes?

What would you suggest to help address these disparities in our own practices?

2 Answers available

How can ethnic representation in clinical research studies in childhood and adult SLE be improved?

This question is part of a collaboration with RheumMadness and is specifically in reference to: EMBRACE

2 Answers available

What is the risk of uveitis flare in patients with JIA and uveitis, who are in remission, when tapering medications?

1 Answer available

Would you discontinue anticoagulation in patients with antiphospholipid antibody syndrome, who have a remote history of thrombotic events and are now negative for pathogenic antiphospholipid antibodies?

Would the answer differ if the index event was arterial vs venous?

3 Answers available

What are your top takeaways from ACR 2022?

4 Answers available

Is there a role for medications, beyond treatment for concomitant psychiatric disorders, in the management of pediatric amplified musculoskeletal pain syndrome?

1 Answer available

In a pediatric patient diagnosed with orbital sarcoidosis (dacryoadenitis) on biopsy, would you recommend completing evaluation for pulmonary sarcoidosis and neurosarcoidosis?

2 Answers available

How long do you continue hydroxychloroquine in pediatric patients with quiescent lupus?

1 Answer available

When do you consider DMARD therapy in patients with persistent oligoarticular JIA who continue to flare in adulthood?

1 Answer available

Do you recommend the use of dexamethasone and anakinra as upfront treatment in a pediatric patient with secondary HLH (nonrheumatic) who is too ill to tolerate etoposide?

This type of etoposide sparing therapy has been previously described in a case series at https://pubmed.ncbi.nlm.nih.gov/32725881/

2 Answers available

Do you repeat antiphospholipid antibody testing in a patient that previously met criteria for APLS?

If so, how long after diagnosis do you do so?

1 Answer available

Papers discussed in this category

Arthritis Rheumatol, 2019 Dec 26

Benefit of Anakinra in Treating Pediatric Secondary Hemophagocytic Lymphohistiocytosis.

Autoimmun Rev, 2017 Sep 09

Can we withdraw anticoagulation in patients with antiphospholipid syndrome after seroconvertion?

Pediatric blood & cancer, 2014-01

The cyclophosphamide equivalent dose as an approach for quantifying alkylating agent exposure: a report from the Childhood Cancer Survivor Study.

Pediatric nephrology (Berlin, Germany), 2015-07

Fertility preservation in patients receiving cyclophosphamide therapy for renal disease.

Arthritis Rheumatol, 2020 Apr

2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases.

Fertil Steril, 2016 Aug 10

Fertility counseling and preservation practices in youth with lupus and vasculitis undergoing gonadotoxic therapy.

Paediatr Drugs, 2017 Aug

Fibromyalgia: Treating Pain in the Juvenile Patient.

Pain Med, 2017 05 01

Trends in Medicalization of Children with Amplified Musculoskeletal Pain Syndrome.

J Neuroimmunol, 2022 Aug 01

Neurosarcoidosis in children: A systematic review and summary of cases, imaging and management.

Diagnostics (Basel), 2019 Oct 25

Pediatric Sarcoidosis: A Review with Emphasis on Early Onset and High-Risk Sarcoidosis and Diagnostic Challenges.

N Engl J Med,

Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis.

Ann Rheum Dis, 2022 Sep 22

Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance.

J Rheumatol, 2009 Oct 15

Ethnic differences in pediatric systemic lupus erythematosus.

ACR Open Rheumatol, 2022 Nov

Association of Race and Ethnicity With Medication Use for Pediatric Lupus in the Childhood Arthritis and Rheumatology Research Alliance Registry.

J Rheumatol, 2009 Jan 22

Autoantibodies in pediatric systemic lupus erythematosus: ethnic grouping, cluster analysis, and clinical correlations.

PLoS One, 2022 Oct 10

Diagnostic test accuracy of novel biomarkers for lupus nephritis-An overview of systematic reviews.

Front Immunol, 2022 May 26

Urine ALCAM, PF4 and VCAM-1 Surpass Conventional Metrics in Identifying Nephritis Disease Activity in Childhood-Onset Systemic Lupus Erythematosus.

Rheum Dis Clin North Am, 2022 Feb

Disparities in Pediatric Rheumatic Diseases.

Lupus Sci Med, 2021 Jan

Apolipoprotein L1 risk genotypes in Ghanaian patients with systemic lupus erythematosus: a prospective cohort study.

Trials, 2020 Oct 27

Discontinuing adalimumab in patients with controlled juvenile idiopathic arthritis-associated uveitis (ADJUST-Adalimumab in Juvenile Idiopathic Arthritis-associated Uveitis Stopping Trial): study protocol for a randomised controlled trial.

Pediatric blood & cancer, 2011-01

Rate of decline of ferritin in patients with hemophagocytic lymphohistiocytosis as a prognostic variable for mortality.

Ther Adv Musculoskelet Dis, 2020 Nov 24

Efficacy of high-dose anakinra in refractory macrophage activation syndrome in adult-onset Still's disease: when dosage matters in overcoming secondary therapy resistance.

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