Biologics or biological disease-modifying antirheumatic drugs (DMARDs) are different from nonbiologic or synthetic DMARDs in that they are produced by biological processes rather than chemical syntheses. Biological DMARDs target specific, well-defined molecules expressed on cells or secreted into the extracellular…
The principal drugs used in pediatric rheumatology are drugs that suppress the inflammatory and immune responses. This chapter outlines important general principles relating to the nonbiological therapies, particularly as they apply to children. The treatment of specific rheumatic disorders is…
Epidemiology The world population is around 7.7 billion of which nearly 30% are children less than 18 years of age. The top five most populous countries have 45% of the world population. Asia has 60% of the world population, with…
Introduction Rheumatic diseases in children are frequently multisystem, chronic, and characterized by periods of disease activity and remission. The disease and therapy can have significant impact on the child physically and emotionally. Early diagnosis of disease through thoughtful, thorough, and…
Introduction Over the past 85 years the role of laboratory investigation in rheumatic diseases has progressed from reports of curious in vitro phenomena in diseases defined purely on clinical grounds to sophisticated immunopathology testing providing information now essential for disease diagnosis.…
Introduction Imaging often plays a key role in establishing the presence, severity, and extent of inflammation of musculoskeletal tissues and can also help monitor disease complications, exclude other diagnoses, and assess treatment response. Imaging can provide early diagnosis and visualization…
Introduction Chronic pain in children and adolescents is commonly defined as any prolonged pain that lasts longer than the expected healing time (arbitrarily defined as greater than 3 months), or any recurrent pain that occurs at least three times throughout…
Introduction Pediatric rheumatic diseases are a broad group of disorders characterized by chronic inflammation, which may have a profound effect on the child’s well-being and may cause irreversible changes in several organs and systems. The aim of the management of…
The critical evaluation of clinical studies is essential for the practice of evidence-based medicine. This chapter will provide readers with sufficient knowledge of study design and data analysis to understand and to begin to assess the quality of clinical investigations.…
Immune defense against microbes is mediated by sequential and coordinated responses, termed innate and adaptive immunity . Innate immunity represents early response mechanisms that facilitate rapid reaction to invading pathogens in the first few hours or days after infection (see…