Susan Bernstein | Issue: February 2017 |
Systemic autoimmune diseases are thought to result from immune dysregulation in genetically susceptible individuals who were exposed to environmental risk factors. Many studies have identified genetic risk factors for these diseases, but concordance rates among monozygotic twins are 25–40%, suggesting that nonheritable environmental factors play a more prominent role.1,2 Through carefully conducted epidemiologic and other…
Nearly all adolescents and young adults (AYAs) with chronic pediatric rheumatic disease require transfer of care to an adult rheumatologist, yet almost half are lost from care at the time of transfer.1-3 Although sometimes framed as a discrete event, transition refers to the longitudinal process, often spanning several years, in which AYAs and their families…
How to recognize distinctions between pediatric and adult arthritis
Dr. Sheffield is an adult rheumatologist who received the following referral request from a family doctor: “Please see this 22-year-old male with a history of juvenile arthritis for ongoing care. I have only seen him once, and have no previous medical records.” Dr. Sheffield meets with Paul, who reports that he has had arthritis since…