Vasculitis in Children

And Other Inflammatory Blood Disorders

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Children with vasculitis need ongoing care from a team of specialists. Early identification of the autoimmune disease and effective treatment are key to minimizing damage to vital organs, including the kidneys, heart, and lungs. Duke pediatric rheumatologists work with other specialists to prevent or treat the organ damage that can result from vasculitis and to put your child's disease into remission.

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Experience Is Key to Identifying Vasculitis in Children

Vasculitis causes inflammation of blood vessels that may impact the flow of blood to organs. Its vague symptoms -- fatigue, skin rashes, fevers, and other common childhood complaints -- makes it difficult to diagnose. Its effects can be severe. Heart, lung, and kidney damage are serious concerns.

Duke pediatric rheumatologists are experts at differentiating between vasculitis and medical conditions with similar symptoms. We treat children with a wide range of inflammatory blood vessel disorders, including Henoch-Schönlein purpura, Kawasaki disease, Takayasu arteritis, and ANCA-associated vasculitis (including microscopic polyangiitis and granulomatosis with polyangiitis).

While vasculitis can be a lifelong condition, it can be controlled through ongoing management. As your child grows, we help transition his or her care to an adult rheumatologist.

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Treatments

The primary treatments for vasculitis are medications that help slow or stop disease progression. Your child may need one or more drugs to prevent inflammation, control the body's immune response, relieve symptoms, or treat complications.

Corticosteroids

Steroids like prednisone can suppress the immune system. They may be prescribed to quickly reduce inflammation. They require careful monitoring to avoid long-term side effects.

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

These medicines, including mexothrexate and CellCept, are sometimes called steroid-sparing drugs and also suppress the immune system. They offer many of the benefits of corticosteroids with fewer side effects but can take longer to work.

Biologics

This newer class of disease-modifying drugs is made from living organisms. These medicines are manufactured using biotechnology methods and target specific parts of the immune system. Certain biologics, including rituximab or tocilizumab, are increasingly being used to treat vasculitis.

Intravenous Immunoglobulin (IVIg)

Certain types of vasculitis, including Kawasaki disease, respond well to IVIg, a blood product that contains antibodies (immunoglobulins) from many healthy donors. This medication might be prescribed for a one-time treatment or more frequently if necessary.

Surgery

Surgery is rare but may be necessary if certain complications are present.

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Diagnosing Vasculitis

An accurate diagnosis is essential for prompt, effective treatment. Discussing your child’s medical history and completing a physical exam is the first step. Additional tests may be necessary to help rule out other illnesses, determine which blood vessels are affected, and assess whether certain organs have been impacted or are at risk. If these tests identify the potential for damage to vital organs or other medical concerns, we work with specialists throughout Duke to coordinate your child's care. As a result, your child's team may include pediatric cardiologists, dermatologists, pulmonologists, kidney disease specialists, and others when necessary.

Blood and Urine Tests

These help detect the presence of inflammation and organ damage.

Biopsies

While your child is under general or local anesthesia, a small piece of tissue is removed for examination under a microscope to inspect the blood vessels and help determine whether your child has vasculitis. Biopsies are usually performed as outpatient surgery, which means your child should be able to go home the same day.

Imaging Tests

CT, MRI, or X-ray scans can rule out tumors, infections, and other medical concerns. They also show whether vasculitis is harming specific blood vessels or organs. These tests can take from 15 minutes to an hour and are virtually painless.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 9 pediatric specialties.

This page was medically reviewed on 05/08/2020 by

Mara L. Becker, MD, MSCE | Pediatric Rheumatologist