Pediatric rheumatologic disease

Pediatric rheumatology encompasses an array of heterogeneous autoimmune and autoinflammatory disorders. Suspicion for rheumatic disease should be high when children present with persistent fevers of unknown origin, arthritis, multiorgan involvement, or unexplained high inflammatory markers. Diagnosis of rheumatologic disease is challenging, as few clinical features are pathognomonic and few diagnostic tests are confirmatory. Infectious and oncologic processes may mimic rheumatic diseases and must be excluded. A child may present to intensive care owing to life-threatening manifestations of an undiagnosed rheumatologic disease or with severe complications of a known disorder. Intensive care unit providers require an understanding of the clinical presentation, diagnosis, and therapeutic management of rheumatologic diseases in order to provide early effective recognition and management of these complex patients..