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Critical care of the pediatric patient with rheumatic disease

Andrew I Shulman1, Marilynn Punaro

  • 1Division of Rheumatology, Department of Pediatrics, University of Texas Southwestern Medical Center and Department of Rheumatology, Children's Medical Center, Texas Scottish Rite Hospital, Dallas, USA.

Current Opinion in Pediatrics
|April 7, 2011
PubMed

Insights

Pediatric rheumatic diseases can be severe, requiring intensive care. Advances in therapy improve outcomes, but immunosuppressed patients with infections face risks, necessitating targeted treatments.

Area of Science:

  • Pediatric Rheumatology
  • Critical Care Medicine
  • Immunology

Background:

  • Childhood rheumatic diseases often require pediatric intensive care due to systemic illness and immunosuppressive treatments.
  • Severe manifestations pose diagnostic and treatment challenges for pediatric rheumatologists and critical care physicians.
  • Conditions like pediatric systemic lupus erythematosus and juvenile dermatomyositis can be life-threatening.

Purpose of the Study:

  • To discuss complications of childhood rheumatic conditions requiring critical intervention.
  • To highlight diagnostic and treatment challenges in severe pediatric rheumatic disorders.
  • To explore the promise of targeted therapies based on disease pathogenesis.

Main Methods:

  • Review of current literature on pediatric rheumatic diseases and critical care management.
  • Analysis of severe disease manifestations and their impact on patient outcomes.
  • Discussion of advances in understanding disease pathogenesis.

Main Results:

  • Therapeutic advances have decreased severe complications and expanded treatment options.
  • Patients with active rheumatic disease, secondary infections, and immunosuppression are at highest risk.
  • Improved understanding of pathogenesis offers potential for more targeted therapies.

Conclusions:

  • Childhood rheumatic conditions can necessitate intensive care interventions.
  • Targeted therapies hold promise for managing these diseases more effectively with fewer adverse effects.
  • Further research into disease mechanisms is crucial for developing advanced treatment strategies.
Abstract

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