University of Iowa Children's Hospital pediatric rheumatologist, Polly Ferguson, MD, chosen as a 2010 Health Care Hero by the Corridor Business Journal, talks about the award and pediatric rheumatology:
How common is arthritis in children?
It is still considered a rare disease, but about 300,000 children in the United States have some sort of arthritis. To give you a reference, it's about as common as juvenile diabetes—which everyone has heard of—but most people haven't heard that children get arthritis.
What causes arthritis in children?
It's a problem with their immune system. Their immune system is triggered by things we don't yet understand and causes chronic inflammation that's directed toward their joints.
Is childhood arthritis similar to adult arthritis?
It is different. Adult arthritis—the majority is osteoarthritis. In childhood arthritis, it's almost all inflammatory arthritis. The immune system in the child has gone awry and is causing damage. So treatment is a lot different.
Is there more than one kind or type of juvenile arthritis?
Yes, there are many kinds—the term that we use for the majority is now juvenile ideopathic arthritis, but even that term is an umbrella for many different types.
What symptoms does a child with arthritis have?
The most worrisome one is stiffness in the morning that's confined to their joints, especially if it lasts for an hour. That is usually means somebody has arthritis. Even in an older person, that's a good marker for arthritis. But children sometimes will present with a limp or somebody will notice that they have a swollen joint.
If parents suspects their child may have arthritis, what steps should they take?
The first thing they should do is go to their primary care provider and let that person know they have concerns. Typically, they'll then pick it up and consult us regarding the care. However, if they think everything is fine and you have a child who is stiff for an hour and has a swollen joint or a limp and aren't' getting any kind of response from their primary care provider; they should call our clinic and we'll be glad to see them. But preferably, we like things to go through their primary care provider.
How is juvenile arthritis treated?
It depends on what kind of juvenile arthritis they have. Almost all of the treatments we have are medications aimed at dampening or quieting the immune response that they have. There are immune modulating drugs and now we have more than we had 10 years ago and they work a lot better. For the majority of children, we have them in remission using medications, so this becomes an inconvenience to them and is not life-threatening.
Will the symptoms of juvenile arthritis subside as the child matures into an adult?
It's a bit of a myth that children with juvenile arthritis all outgrow it. The reality is that only occurs in a small minority, so most go on to have persistent disease into adulthood.
Tell us briefly about being recognized as a HealthCare Hero? How did this award come about?
It came about because of the folks at the Arthritis Foundation, the Iowa chapter, nominated me and got several people here to write letters. It was really spearheaded by the Arthritis Foundation. I think that it was a really nice honor. I was just amazed by the other people that were awarded the HealthCare Hero. I was just really proud to be in their company; there were some amazing recipients this year. It was very nice. |
