Juvenile arthritis is common autoimmune disease among children
Childhood Autoimmune Disorders
Celiac disease, juvenile rheumatoid arthritis, and type 1 diabetes are among the autoimmune disorders that children can develop.
By Madeline R. Vann, MPH
Medically Reviewed by Pat F. Bass III, MD, MPH
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Autoimmune disorders are very rare in children, but if your child or someone in your family is coping with one, you naturally will have concerns. Many parents worry about whether there is a relationship between pregnancy and childhood autoimmune disorder risk, and about the impact of autoimmune disorder treatment on their children.
Common Autoimmune Disorders in Childhood
“The most common autoimmune disorder that I know of in children would be celiac disease,” says Jane M. El-Dahr, MD, professor of clinical pediatrics and chief of the section of pediatric immunology, allergy, and rheumatology at Tulane University School of Medicine in New Orleans. “Celiac disease (gluten or wheat sensitivity) affects 1 to 3 percent of the population and is woefully under-diagnosed. It is hard to think of another one that would be as common as 1 percent of the population.”
Other autoimmune disorders that occur in childhood include:
- Juvenile arthritis, which affects about 1 in 1,000 children
- Type 1 (juvenile) diabetes, which affects 1 to 2 of every 10,000 children
- Immune (or idiopathic) thrombocytopenia purpura, which occurs in 3 to 8 out of 100,000 children.
Pregnancy and Autoimmune Disorder Risk in Children
As a mother, it's natural to wonder whether you could pass on your autoimmune disorder to your child or in some other way cause your child to have an autoimmune disorder. “If a pregnant woman has an autoimmune disorder — for example, lupus — those antibodies can be passed through the placenta to the infant, who then will have the same antibodies for four to six months and may have symptoms … which get called neonatal lupus in this example,” explains El-Dahr.
Strictly speaking, pregnant women do not permanently pass their autoimmune disorders on to their children. But when you're pregnant, you should make sure your doctors are aware of both your autoimmune disorder status and your family history for the following reasons:
- You may have to change the medications you use to manage your autoimmune disorder during pregnancy.
- Mothers who have antibodies to their own platelets can cause bleeding problems in their infants. For this reason, the babies are usually delivered by cesarean section with precautions to prevent bleeding or injury.
- In general, autoimmune disorders are known to have a genetic component. If you have an autoimmune disorder or if they're common in your family, there is an increased risk for your offspring to develop an autoimmune disorder. However, you and your children may not develop the same disorders.
Concerns About Treating Children With Autoimmune Disorders
In years past, the impact of medications such as steroids on growth was one of the dominant concerns for both physicians and parents trying to help children with autoimmune disorders.
“The biggest concerns of treatment would be the use of steroids affecting growth for those who take prednisone, but even more is the psychological impact of having a serious chronic disorder,” says El-Dahr. Modern medicines are much more targeted, depending on the autoimmune disorder in question, so the impact on growth is less of a concern.
Today, parents and physicians recognize that the emotional and psychological impact of having an autoimmune disorder requires attention. Children and teens may need help:
- Coping with the diagnosis of a lifelong chronic illness.
- Coping with family tensions.El-Dahr notes that divorces make this more complicated, especially when parents are not on the same page about how to manage their child’s autoimmune disorder.
- Coping with peers.Depending on the disorder, children may face teasing or ostracism at school. For example, children with Crohn’s disorder or ulcerative colitis often face teasing because of how often they need to go to the bathroom or because their peers mistakenly think their disorder is contagious.
El-Dahr recommends finding support groups to help with these and other concerns. Internet support groups make it possible for families coping with a rare autoimmune disorder in childhood to find other people in the same situation over great distances.
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