Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and the presence of circulating autoantibodies directed against self-antigens. SLE occurs in both children and adults, disproportionately affecting females of reproductive age. Although nearly every organ may…
In addition to causing arthritis by means of direct microbial infection (i.e., septic arthritis; see Chapter 705 ), microbes activate innate and adaptive immune responses, which can lead to the generation and deposition of immune complexes as well as antibody…
The diseases collectively referred to as spondyloarthritides include ankylosing spondylitis (AS) , arthritis associated with inflammatory bowel disease (IBD) or psoriasis, and reactive arthritis following gastrointestinal (GI) or genitourinary (GU) infections ( Table 181.1 and Table 181.2 ). Spondyloarthritis is…
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and one of the more common chronic illnesses of childhood. JIA represents a heterogeneous group of disorders sharing the clinical manifestation of arthritis. The etiology and pathogenesis of…
Nonpharmacologic as well as pharmacologic interventions are often necessary to meet the desired goals of disease management. Optimal disease management requires family-centered care delivered by a multidisciplinary team of healthcare professionals providing medical, psychological, social, and school support. Rheumatologic conditions…
Rheumatic diseases are defined by the constellation of results of the physical examination, autoimmune marker and other serologic tests, tissue pathology, and imaging. Defined diagnostic criteria exist for most rheumatic diseases. Recognition of clinical patterns remains essential for diagnosis because…
Adverse drug reactions can be divided into predictable (type A) and unpredictable (type B) reactions. Predictable drug reactions , including drug toxicity, drug interactions, and adverse effects, are dose dependent, can be related to known pharmacologic actions of the drug,…
Adverse reactions to foods consist of any untoward reaction following the ingestion of a food or food additive and are classically divided into food intolerances (e.g., lactose intolerance ), which are adverse physiologic responses, and food allergies, which are adverse…
Serum sickness is a systemic, immune complex–mediated hypersensitivity vasculitis classically attributed to the therapeutic administration of foreign serum proteins or other medications ( Table 175.1 ). Table 175.1 From Aceves SS: Serum sickness. In Burg FD, Ingelfinger JR, Polin RA,…
Anaphylaxis is defined as a serious allergic reaction that is rapid in onset and may cause death. Anaphylaxis in children, particularly infants, is underdiagnosed. Anaphylaxis occurs when there is a sudden release of potent, biologically active mediators from mast cells…