When Children Have ‘Adult’ Diseases
Early diagnosis and treatment are important
Walking for health—Robbie, age 9, of Coopersburg has had juvenile rheumatoid arthritis since age 3. Regular injections of two drugs keep his joints flexible and ease pain. “I might be a little slower,” he says, “but I can do everything the other kids do.” In photo above, he prepares for the Lehigh Valley Children’s Arthritis Walk with his parents, Shani and Frank Fassbender, sister Shelby, and Robbie’s doctor, pediatric rheumatologist C. April Bingham, M.D.
An infant with arthritic joints, a fifth-grader complaining of migraines, a teenager with type 2 diabetes—what’s going on? “Children and adolescents can and do get diseases usually associated with adults,” says pediatrician John Van Brakle, M.D., of Lehigh Valley Hospital and Health Network.
Some of these conditions can be prevented and all can be treated. “The key is to get regular checkups so your child’s doctor can spot indicators of a developing illness,” Van Brakle says. “Prompt treatment is important in helping children with a chronic disease live as normal a life as possible.” Read about some of the more common diagnoses on these pages, with insights from Van Brakle and his colleagues. Lehigh Valley Hospital, unlike most, has a full team of pediatric subspecialists even in less common areas such as endocrinology and rheumatology.
Juvenile Rheumatoid Arthritis (JRA)
Who’s at risk—Girls more than boys, and children whose families have autoimmune disorders. JRA affects about 300,000 children in the United States.
Cause—The body’s immune system mistakenly attacks healthy cells in the joints.
Symptoms—Recurring joint pain, joint swelling, fever and/or rash.
Treatment—Oral or injectable medications (often immunosuppressant), physical therapy and exercise.
Prevention—There is no way to prevent most autoimmune disorders.
Outlook—“With regular checkups and medication, most children with JRA lead healthy, active lives,” says pediatric rheumatologist C. April Bingham, M.D.
Migraine Headaches
Who’s at risk—Children (especially girls) with family history of the problem. Migraines affect 5 percent of elementary schoolers and 20 percent of teens.
Cause—Probably a combination of low serotonin levels, blood vessel dilation or constriction, and other factors. Menstrual periods, certain foods and skipping meals are potential triggers.
Symptoms—Pounding headache with nausea; light and sound sensitivity.
Treatment—Have the child lie down in a cool, dark room and give prescribed medication as soon as the headache begins. Don’t overuse drugs. “The problem may resolve just by evening out your child’s sleep pattern, meals and fluid intake,” says pediatric neurologist Boosara Ratanawongsa, M.D.
Prevention—A food diary helps identify triggers to avoid (such as processed meats, chocolate and cheese). Also avoid caffeine.
Type 2 Diabetes
Who’s at risk—Overweight teens and children.
Cause—A diet high in the wrong carbohydrates and fats, heredity, lack of exercise. Symptoms—Your child won’t feel sick, but obesity is a warning sign—20 percent of obese teens are prediabetic.
Treatment—Lifestyle change, medication, insulin if needed.
Prevention—Healthy diet (vegetables, fruits, whole grains, lean meats) and daily exercise.
Outlook—“People who develop type 2 diabetes as teens face a future of health problems including heart disease if the condition is not well-controlled,” says pediatric endocrinologist Arnold Slyper, M.D.
Low Bone Mineral Mass
Who’s at risk—Anorexic girls and boys, undernourished female athletes, people with celiac disease, inflammatory bowel disease and conditions requiring long-term steroid use. The theory that carbonated beverages (especially colas) raise fracture risk is not proven.
Cause—Lack of calcium and other bonebuilding minerals. Symptoms—No early symptoms, though stress fractures may be a red flag. Doctors can test bone mineral density.
Treatment—Calcium-rich diet, calcium supplements, vitamin D, exercise.
Prevention—Make sure your child gets plenty of calcium (dairy foods, etc.) and weight-bearing physical activity.
Outlook—Osteoporosis in adulthood and increased risk for broken bones. “Bonebuilding happens from childhood into early adulthood. After that, you can’t regain what you failed to build,” says adolescent medicine specialist Sarah Stevens, M.D.
Want to Know More? Children also can develop ulcers, gastric reflux, fibromyalgia and chronic fatigue. For more on those conditions or on preventing type 2 diabetes, call 610-402-CARE or click here.
Published from Healthy You Magazine, September-October 2008
This page last updated 8/24/08 09:47 AM
