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As a pediatric rheumatologist, I care for children who have autoimmune disorders such as lupus, dermatomyositis, arthritis, vasculitis, Kawasaki disease, fever syndromes, and more. These conditions cause the immune system to malfunction, leading to symptoms such as chronic fever, rash, weakness, weight loss, and stiff, painful, swollen joints.

By the time I meet a child and his or her family, they have often seen many doctors but are still no closer to a diagnosis. Frustration is common and understandable, and my goal is to provide answers and develop a treatment plan that provides relief.

At your child’s first appointment with the team at the Pediatric Rheumatology Program, part of Hassenfeld Children’s Hospital at ��������Ƶ, we start with a conversation. I listen to my patients so I can understand the impact that chronic pain has on the entire family. I believe in limiting the “doctor speak” and instead talk in terms that everyone can understand. I encourage everyone to ask questions. Good communication with children and families is key to building trust.

Every system in the body can be affected by autoimmune disease, so we perform a careful history and exam that covers neurologic, skin, kidney, and lung diseases. I perform an extensive rheumatologic physical exam with an emphasis on the musculoskeletal system. This can help determine whether a rheumatologist, or perhaps other specialist such as an orthopedist, would be more helpful for your child. I also observe the way a child moves and interacts. This is just as important as any lab test in coming to a diagnosis. I order blood tests and diagnostic exams only as necessary.

Our team is participating in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry, which aims to help us better understand rheumatologic disease in children, adolescents, and young adults, and the long-term effects of disease and the medications used as treatment. We are also assisting in the validation of the adult lupus criteria to see whether it is applicable for children with lupus and validating a revision for the classification of juvenile arthritis. In addition, we are researching whether certain cytokines, such as interferon, play a more significant role in autoimmune disease than currently understood.

No matter the diagnosis, I always aim to leave a family feeling hopeful. As soon as we have an answer, we can be optimistic that proper treatment can help a child to feel well again.