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Autoimmune Diseases In Children – Symptoms And Treatment
Imagine this. Your child goes out in the cold and comes back wheezing and sneezing. Or he eats something outside and falls sick with diarrhea. He plays in the sun and gets rashes all over his skin.
Sounds scary, right? This is what would happen if our immune system is not working the way it should. And not everybody has a robust immune system. Sometimes, the immune system can dangerously turn against our body. It attacks our body instead of protecting it from antibodies. This condition could happen in adults as well as children. This is when autoimmune diseases occur.
Autoimmune diseases in children are rare, and when they happen, the disorders can disappear on their own as the child grows up. But there are certain diseases which need treatment. MomJunction tells you how autoimmune disorders can attack any part of our body, why such conditions happen, and how we can deal with them.
What Are Autoimmune Diseases?
An autoimmune disease occurs when the immune system attacks the healthy tissues in the body, mistaking them to be antigens or foreign bodies. The autoimmune disorder can result in 80 diseases, but not all of them are common in children (1).
The diseases fall into two categories: Localized and systemic. Localized diseases affect a particular organ such as liver, thyroid, and adrenal glands, while systemic autoimmune diseases spread to multiple organs from skin to kidneys and heart. The disorders can affect any part of your child’s body, including:
- Blood vessels
- Connective tissues
- Endocrine glands such as the thyroid or pancreas
- Red blood cell
Common Autoimmune Diseases in Children:
Multiple organs can be affected by the disorder. Most of these are rare autoimmune diseases. Also, several pediatric immune disorders happen more often in girls than in boys.
1. Addison’s disease:
Also called pediatric adrenal insufficiency, it occurs if the adrenal glands do not produce sufficient amount of two steroid hormones cortisol and aldosterone. Cortisol influences the child’s metabolism and immune system and controls inflammatory reactions. Aldosterone manages sodium and potassium levels (2). Addison’s disease is, however, rare.
2. Autoimmune liver disease:
Also known as autoimmune hepatitis, the inflammatory disorder damages the liver and could lead to cirrhosis. Type I is less common in children. Type II, too, is rare but more common than type I. It usually affects girls of two to 14 years of age (3).
3. Autoimmune thyroiditis (AT):
Autoimmune thyroiditis usually occurs in adolescents, but can be prevalent even in younger children. This is the most common thyroid disease in children. AT can be either hypothyroidism or hyperthyroidism. Genes and environmental factors cause the disease in children (4). Therefore, those with a history of thyroiditis in their family are more susceptible.
4. Celiac disease:
The digestive disorder affects the small intestine if the child eats foods that contain the protein gluten. Such foods include wheat, barley, and rye and cooked foods such as bread, pasta, etc. One in 141 people in the US have this disorder, but most remain oblivious to it (5). Girls are more vulnerable than boys, and it can also be hereditary.
5. Henoch-Schonlein purpura (HSP):
In an HSP affected child, the inflamed skin leaks red blood cells causing rashes in the legs, buttocks, and arms. The condition can also target the internal organs. In the US, HSP occurs in 20 per every 100,000 children, and boys are more vulnerable than girls. This kind of autoimmune rashes in children can develop between two and 11 years of age (6).
6. Immune (or idiopathic) thrombocytopenia purpura (ITP):
In this condition, the immune system destroys the platelets in the child’s body, mostly in the spleen (7). Platelets help in clotting the blood. Therefore, when their count is low, bleeding could become uncontrollable. Medical practitioners are yet to know the cause of the condition, but it could be the result of a non-contagious virus. Also, ITP could occur if the child has any other autoimmune disorders.
7. Juvenile arthritis (JA):
Also called pediatric rheumatic disease, JA can affect children aged below 16 years. Nearly 300,000 children in the US are affected with this condition (8). JA is a collective name given to various rheumatic diseases in children, affecting different body parts from musculoskeletal system to eyes, skin, muscles, and gastrointestinal tract.
8. Juvenile dermatomyositis:
Juvenile dermatomyositis is an inflammation of muscles (myositis), as the faulty immune system attacks blood cells throughout the child’s body. The condition is very rare as three in one million children are affected in the US every year (9). It mostly occurs in children of five to ten years of age.
9. Juvenile scleroderma:
Scleroderma means hard skin, wherein thick scar tissues are formed on the child’s skin. There are two types of scleroderma: localized and systemic. Localized is more common than systemic in children. Localized scleroderma does not spread to the underlying muscles while systemic can attack the internal organs such as the heart, GI tract, lungs, and kidneys.
Girls are more vulnerable than boys. The US has just about 5,000 to 7,000 children suffering from this rare disease. Among those affected, 1.5% get it before 10 years of age while 7% develop it between 10 and 19 years (10).
10. Kawasaki’s disease:
The rare disease occurs due to inflammation of the muscles in the body, especially the coronary vessels in the heart. It starts with a fever and continues for around five days. Children aged below five years are susceptible, and one in 10,000 children is affected (11).
11. Pediatric lupus (SLE):
Systemic lupus erythematosus or lupus happens in many forms and damages joints, skin, kidneys, heart, lungs, blood vessels, and brain among other organs. The disease is uncommon in children below five years, but 15% of those affected by the disorder are younger than 18 years (12).
12. Type 1 diabetes (juvenile):
Type 1 diabetes is a chronic disease wherein the pancreas stop producing the insulin hormone. The disease can develop at any age but is more common in people aged below 20 years. Over 200,000 youth below 20 years are estimated to be suffering from this disease in the US (13).
13. Multiple autoimmune syndrome (MAS):
MAS is the combination of three or more autoimmune diseases in a person. One of the disorders pertains to skin – either scleroderma or psoriasis. Around 25% of the people suffering from an autoimmune disease are likely to get more autoimmune disorders (14).
Autoimmune disorders can target any part of our body. And why do they do so? Unfortunately, medical fraternity is yet to understand the exact cause for these immunological diseases and conditions.
Causes For Overactive Immune System:
Autoimmune diseases are ‘idiopathic’ meaning that their cause is unknown. However, based on some common traits, scientists believe that a combination of multiple factors causes the diseases:
- Heredity: The autoimmune problems could pass on to a child from her parents. Also, if a woman is carrying an autoimmune disorder when she is pregnant, she could pass on the antibodies to the child in the womb. In such cases, the symptoms may disappear in a few months.
- Genetic: In 2013, National Institutes of Health (NIH) and National Cancer Institute (NCI) scientists in the US have found that abnormalities in the gene called Bach2 caused autoimmune diseases (15).
NCI principal investigator Nicholas P. Restifo says: “Although genes have been found that play specific roles in either inflammatory cells or regulatory cells, Bach2 regulates the choice between the two cell types, resulting in its critical role in maintaining the immune system’s healthy balance.”
- Hormonal effects: Medical experts assume that hormones in our body have an influence on the disorders because most of the autoimmune problems happen to women than men. Female hormones could make the immune system react in a way that it hurts the body itself.
- Environmental factors: The disorders generally remain dormant until some external elements, such as sunlight, virus, a drug, or radiation trigger them. For instance, a virus can enter the body and alter the cells, which could make the immune system attack the body.
Similarly, faulty cells can produce abnormal antibodies.
Studies are still ongoing to identify the genes that cause pediatric immune disorders, and the environmental and hormonal factors influencing them.
Causes as seen by Naturopathy Practitioners:
Meanwhile, naturopathy considers various other reasons for these diseases (16):
- Immature immune system: Naturopathy practitioners believe that overzealousness in protecting the child from any infections hampers the development of his immune system. Therefore, if you are averse to your child playing in a muddy pool, clean his hands and feet obsessively every time he touches something, or are too careful in dealing with his common cold, his immune system will not completely develop its defense mechanism.
- Leaky gut syndrome: The imbalance of microbial flora, called dysbiosis, in the digestive tract, can allow bacteria and endotoxins to collect in the bloodstream due to a leaky bowel wall. This could lead to inflammatory bowel disease, chronic fatigue syndrome, and similar ailments.
- Excess inflammation: Consumption of inflammatory foods, especially the C-reactive protein (CRP), can lead to inflammations.
Symptoms Of Autoimmune Diseases In Children:
The signs are many and varied because the diseases target not one but several organs. There are no specific symptoms that can be associated with these disorders. However, the most prevalent signs are:
- Infection and inflammation of internal organs
- Cramps, loss of appetite, diarrhea, nausea and other digestive problems
- Delayed growth and development
- Anaemia or low platelet counts
- Frequent sinus infection, pneumonia, bronchitis
- Joint pain
- Ear infections
- Skin infections
- General ill-feeling (malaise)
- Dry eyes and mouth
- Hair loss
- Weight loss
All the above symptoms are non-specific in the sense that they need not necessarily point at an autoimmune disorder but could be a simple, temporary health problem. However, if your child is suffering from these symptoms frequently, it could be indicative of a health problem. In such cases, take her to a pediatrician for further analysis and diagnosis.
Diagnosis Of Degenerative Autoimmune Diseases:
Diagnosis is a challenge for doctors as the symptoms are not unique to autoimmune disorders. The doctor would initially do a physical examination and understand the child’s medical history. Later, he may recommend various tests based on the affected organs:
- Antinuclear antibody tests: Antinuclear antibody (ANA) test is the primary test done to diagnose systemic disorders. ANA are the autoantibodies that attack the matter present in the nucleus of a cell.
ANA test is done using two methods, indirect fluorescent antibody (IFA) and immunoassay. In IFA, the affected child’s blood sample is combined with cells. If antibodies are present in blood, they react with the cells. Immunoassays are less accurate than IFA.
The doctor may recommend other autoantibody tests along with ANA, to observe specific substances within cell nuclei.
- CBC: The complete blood count (CBC) test gives details about three components, red blood cells, white blood cells, and platelets. It gives the count of each component and physical features of the cell such as its size, shape, and content.
- Comprehensive metabolic panel: CMP is a blood test done to check for anomalies in the kidney, liver, and diabetes. It checks for total bilirubin, total protein, potassium, sodium, glucose, and carbon dioxide among others.
- C-reactive protein: The liver produces CRP in response to high inflammation. The CRP test is done to screen inflammatory bowel disease, rheumatoid arthritis, and lupus. As the CRP blood test can indicate more than one disorder, your doctor may recommend other tests to confirm an autoimmune disease.
- Erythrocyte sedimentation rate (ESR): Your child’s physician may recommend an ESR test if he suspects juvenile idiopathic arthritis, lupus, Kawasaki disease, or SLE. This is a non-specific test because it identifies inflammation in the body but does not specify the organ in which the anomaly exists. Therefore, the physician usually recommends ESR along with CRP or other tests.
- Urinalysis: Urinalysis involves several tests to examine the physical, microscopic, and chemical appearance of the child’s urine. The test is done to diagnose urinary tract infections, kidney problems, liver disorders, and diabetes, to name a few.
Once the doctor diagnoses the cause and understands the severity of the problem, he will recommend certain changes in the child’s diet and routine if the disorder is minor or temporary.
So, would those minor changes be enough to address the problem? No, serious diseases need medical intervention.
Treatment For Autoimmune Diseases In Children:
The treatment of the disorders aims at reducing the symptoms, controlling the damage done by autoimmunity, and maintaining the body’s ability to fight the disease.
Each childhood autoimmune disease has a unique treatment but commonly include:
- Supplements: Your physician may prescribe supplements to replenish the vitamins, hormones (such as thyroid), or insulin in the child’s body.
- Blood transfusion: In the case of disorders such as ITP, or to the liver and kidneys, your child may need a blood transfusion as the body produces less blood or fewer platelets, among other things.
- Physical therapy: Diseases related to bones, joints, or muscles need physical therapy to make the body parts move easily and strengthen the muscles.
- Nonsteroidal anti-inflammatory drugs: The NSAIDs or painkillers, such as ibuprofen and naproxen, give relief from swelling, pain, and stiffness. They suppress the inflammatory pain caused due to some diseases such as rheumatoid arthritis.
- Disease-modifying anti-rheumatic drugs (DMARDs): The drugs such as methotrexate, sulfasalazine (brand name Azulfidine) and leflunomide (Arava), control the pace at which the disease spreads. It slows down the rate. These are commonly used for rheumatoid arthritis, to alleviate pain and inflammation, and control joint damage.
- Biologics: Biologics are a new class of drugs that are genetically engineered proteins. They target the specific organs attacked by the immune system. They are DMARDs used for patients with persistent disease activity. Etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira) are some of the biologics in use.
- Corticosteroids: Corticosteroids are hormones produced by the adrenal glands. They are available in various forms, including tablets, injections, inhalers, and lotions. The drugs, used to fight inflammation and control the immune system, are so powerful that doctors prescribe them only in small doses. High doses are likely to have long-term side effects. Prednisone is one such corticosteroid.
- IVIg (intravenous immunoglobulin): IVIg is immunoglobulin G antibody pooled from multiple plasmas collected from multiple donors. They help in controlling idiotypic antibodies and mitigating inflammatory mediators among others.
Depending on your child’s autoimmune disease, she may need other kinds of medical treatment, such as:
- Plasmapheresis: It is a physical process to remove plasma. Plasma carries antibodies in the blood. The doctor would recommend the procedure only in extreme cases as plasmapheresis flushes good antibodies as well.
- Surgery: In certain complicated cases of juvenile idiopathic arthritis or bowel obstruction in Crohn’s disease, doctors may recommend surgery.
The pain, inflammation, and the trouble associated with the conditions could be traumatic for the child. Along with medication and physical therapy, he might need psychotherapy or counseling to be strong during these testing times.
In addition to taking the child to the doctor, what can you do? Support her by taking precautions such as giving allergen-free diet, nutritional supplements like vitamin B and C, and healthy lifestyle changes.
Alternative / Complementary Remedies For Autoimmune Diseases:
My cousin’s daughter has rheumatoid arthritis. She has been taking allopathic medicine but my cousin and her husband decided to go for alternative therapies as well. They visited a noted naturopathy practitioner, who made the problem more manageable for the little girl.
You may try alternative medications, remedies and therapies to support the main course of treatment:
- Natural molecule: A group of researchers at Brigham and Women’s Hospital (BWH), US, came up with a potential treatment for autoimmune disorders in 2014 (17). They have discovered that a natural molecule Nicotinamide adenine dinucleotide (NAD+) that occurs in living cells, plants, and food, can be used to control the problem. NAD+ turns the destructive cells into protective cells, thus overturning the autoimmune system. It can also restore the damaged tissue.
BWH Division of Transplant Surgery and Transplantation Surgery Research Laboratory, senior study author Abdallah ElKhal says, “Our study is the first to show that NAD+ can tune the immune response and restore tissue integrity by activating stem cells.”
- Probiotics: Lactic acid-producing bacteria (LAB) probiotics have anti-inflammatory effects. According to a research report published in BMC Complementary and Alternative Medicine (18), patients who took the probiotic Bacillus coagulans GBI-30, along with their regular medication for rheumatoid arthritis showed greater improvement than those who did not take the probiotic.
Note that the above two methods are still in the research stage, and may not be readily available as a treatment.
- Naturopathy: If you want your child to avoid any side effects of the mainstream medicines, you may try natural ways. Naturopathy aims to target the specific causes:
- It seeks to improve a child’s immune system by discouraging indiscriminate use of vaccines for every minor ailment. It is against suppression of fever that is less than 103oF and encourages the natural ability of the body to fight foreign bodies.
- Plug the leaky gut by reducing and rotating the allergy-causing foods such as cows’ milk, fish, eggs, yeast, wheat, soy, chocolate, and pork.
- Give your child a lot of fruits and vegetables to control the CRP level in the body. Foods rich in fiber and flavonoids reduce inflammation.
- Chiropractic care: The practitioners of chiropractic care use spinal manipulation or adjustment to treat problems in the musculoskeletal and nervous systems. Spinal manipulation involves a manual application of controlled force into the joints to restore their mobility. This treatment may rarely cause soreness or aching, which disappears in 12 to 48 hours (19).
You may also consider two other alternative therapies acupuncture and hypnosis.
Am I suggesting that these alternatives are better than the main course of allopathy medicine? No. Proper diagnosis and an expert advice are a must before you opt for any of the alternatives. Also, you need to visit the best professional in these areas to ensure that you are not harming your child.
Home Tips For Autoimmune Diseases In Kids:
Seeing your child suffer is very painful. You would want to do anything to make her feel better. Therefore, bring changes in your child’s diet and lifestyle for her to cope with the situation. Here are a few home remedies for autoimmune diseases you can follow:
- Give your child a pineapple or papaya after meals as the proteolytic enzymes in them support digestion.
- Do not give her liquids along with meals as this dilutes hydrochloric acid.
- Reduce saturated and trans fats.
- Increase the amount of omega-3 fatty acids through fish or fish oil supplements, walnuts, flax seeds, and similar foods.
- Cut down on refined foods such as pasta and white rice.
- Give her a lot of whole grains such as oats and brown rice.
- Add ginger and turmeric in the child’s food as they have an anti-inflammatory effect.
Autoimmune diseases in childhood occur as the immune system fails to differentiate between an individual’s body and foreign antibodies. They can attack any one or multiple organs. While a few could be long-term disorders, some might disappear in a few days. As a parent, you need to be strong and make your child feel as normal as possible lest it affects her psyche. Take care of her routine, and food consumption to make the problem less worrisome.
Frequently Asked Questions
1. Can autoimmune diseases be cured?
There is no permanent cure for autoimmune diseases. The medicines can suppress or alleviate the pain. However, modern research and non-allopathic treatments are coming up with ways to target the cause of the issue. As most of the autoimmune disorders are linked to leaky gut, scientists believe that a plug to this could help cure the diseases (20).
2. What is leaky gut syndrome?
Inflammation creates large spaces in between the cells bordering the intestines. They become leaky and allow toxins, bacteria, bad fats, and other unhealthy materials seep into the blood stream through the gut membrane. In short, a leaking gut wall invites the toxic substances into our body, triggering the immune system to become hyper-defensive.
3. Is cancer an autoimmune disease?
According to Cancer Research UK, there is no direct connection between autoimmune diseases and cancer. A person with autoimmune disorders is as likely as a normal person to get cancer. However, certain types of cancer are more likely to happen in people with particular autoimmune diseases.
For instance, researchers at the Medical College of Wisconsin have found that systemic sclerosis increased the risks for lung cancer by five times, liver cancer by three times, and nonmelanoma skin cancer by four times (21).
According to a study in Shanghai, the risk of esophageal cancer increased 2.4 fold in patients with autoimmune diseases.
4. Is psoriasis an autoimmune disorder?
Yes, psoriasis occurs due to a faulty immune system. The skin disease involves a white blood cell called a T cell. The T cells become hyperactive, leading to inflammation of the skin and rapid production of skin cells. Psoriasis is rare in children.
5. What type of doctor treats autoimmune diseases?
Take your child to a pediatrician. He will be the main doctor, who would suggest the specialist or specialists you need to visit. For example, if your child has an autoimmune problem with the digestive system, he might have to see a gastroenterologist; if it is an issue with the kidneys, then he needs to approach a nephrologist. Rheumatologists, the specialists in joints and connective tissue disorders, usually diagnose autoimmune illnesses.
Have you or your child suffered through autoimmune diseases? How did you overcome them? Do share your experiences with our readers, in the comment section.