With some notable exceptions, such as celiac disease, pediatric autoimmune disease is fairly uncommon, but when it occurs, it an present the physician with diagnostic and therapeutic challenges. With autoimmune diseases, of which there are more than 80, something causes the immune system to attack apparently healthy tissues, including joints, muscles, skin and those of the digestive tract. Common manifestations are skin rashes, achy muscles, gastrointestinal discomfort and sore joints.
Some of the more common pediatric autoimmune diseases include type-1 diabetes, juvenile arthritis, lupus and celiac disease, as indicated above. While a collaborative approach to diagnosis and treatment is normal for children with autoimmune diseases, and may involve any number of specialists (depending on symptoms and pathology), the primary specialist who generally leads these efforts is known as a pediatric rheumatologist.
If I have an autoimmune condition, what are the chances my child(ren) will also have an autoimmune condition?
Some autoimmune diseases – particularly lupus and multiple sclerosis – appear to run in families, so there may be a slight risk of passing your autoimmune condition to your child. That is, inheriting certain genes may make it more likely that your child develops an autoimmune disease, but a combination of other factors are likely to be involved as well. It’s also unclear whether this represents true genetic inheritance, or a transfer of the offending antibodies (that attack one’s own tissues) from mother to fetus. You should check with your ob/gyn and rheumatologist regarding your particular disorder(s).
Does having an autoimmune disease affect pregnancy?
It depends on the disease. Most women with an autoimmune diagnosis can become pregnant and deliver without major incident. However, depending on the disorder and symptoms during pregnancy, there are also some potential risks. For example, lupus patients have a higher chance of premature delivery, and less frequently, stillbirth. Those with myasthenia gravis often develop breathing problems while pregnant. Interestingly, some women report a decrease in symptoms during pregnancy, while others notice an exacerbation. This is often disease-specific, with relatively characteristic reactions among pregnant women, though obviously no two pregnancies are the same.
If my child does have an autoimmune condition, what are the most common symptoms for infants, toddlers and children?
A common autoimmune disease in both infants and older children is celiac disease, which is a condition of the small intestine that hinders the digestion of foods containing gluten, commonly found in wheat products. Infants who are bottle-fed will display the first signs of the disease such as unremitting diarrhea, bloating, colic, weight loss and vomiting. With Crohn’s disease or ulcerative colitis (collectively known as inflammatory bowel disease, or IBD), symptoms often include diffuse abdominal pain, constant diarrhea (sometimes bloody), weight loss, and possibly dehydration. Juvenile idiopathic arthritis usually appears in kids between six months and 16 years of age and involves reddened, swollen and/or painful joints. A child with type-1 diabetes will have excessive thirst and urination, lethargy and possibly blurred vision, among others. Skin rashes and fatigue are common symptoms of autoimmune diseases that occur in all ages, and other more specific signs and symptoms may be seen, and vary by condition.
If you have an autoimmune disease, talk to your doctor before attempting to become pregnant. He or she may advise you to wait until a period of remission, and/or stop certain medications, before trying to conceive. Further, autoimmune disease can cause fertility problems, so ask your doctor what fertility tests and treatments are available if this applies to you.
Questions for your doctor:
- What are some diet and lifestyle changes I can take to prepare my body before I try getting pregnant?
- Is there a gene test that my partner and I can take that will tell us what autoimmune antibodies we both have before we start trying?
- What factors during pregnancy cause my autoimmune symptoms to get better?
Questions for your pediatrician:
- If my child has eczema or other skin autoimmune issues, what are the chances that s/he might develop other related issues such as allergies and asthma? How should we watch for this as she grows?
- What kind of non-prescription therapies can we try to alleviate symptoms for my child? How can diet help with symptoms?
- At what age can children take herbs to help with symptoms?
- What are the key ages that my child might have onset of an autoimmune condition?
- Is there an age where we can assume s/he did not inherit an autoimmune gene?
About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians. After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time. He may be reached at firstname.lastname@example.org.