Pediatric Clinics of North America RSS feed: Current Issue. Pediatric Clinics of North America provides the latest clinical information on health issues for children and adolescents. Each bimonthly issue focuses on a single topic and is written by pediatricians with proven experience. You'll receive cutting-edge, expert reviews of current diagnosis and treatment that can be applied directly to your practice. In addition, you can earn valuable CME credits - up to 90 per year - with your subscription. http://www.pediatric.theclinics.com/?rss=yesElsevier Inc.en © 2012 Elsevier Inc. All rights reserved. Pediatric Clinics of North America0031-3955592April 2012 © 2012 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.pediatric.theclinics.com/article/PIIS0031395512000430/abstract?rss=yesCME Accreditation Page and Author Disclosure10.1016/j.pcl.2012.04.001Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1iiiiiihttp://www.pediatric.theclinics.com/article/PIIS003139551200034X/abstract?rss=yesContributors10.1016/S0031-3955(12)00034-XPediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1vvihttp://www.pediatric.theclinics.com/article/PIIS0031395512000351/abstract?rss=yesContents10.1016/S0031-3955(12)00035-1Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1viixhttp://www.pediatric.theclinics.com/article/PIIS0031395512000363/abstract?rss=yesForthcoming Issues10.1016/S0031-3955(12)00036-3Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1xixihttp://www.pediatric.theclinics.com/article/PIIS0031395512000168/abstract?rss=yesThe pediatric rheumatic diseases comprise a diverse group of disorders that range from mild and self-limited (eg, transient synovitis) to devastating and fatal (eg, macrophage activation syndrome). They can be extremely well-localized (eg, oligoarthritis affecting only one joint) or involve multiple systems (eg, systemic lupus erythematosus). A solid knowledge of the basic sciences such as biochemistry, immunology, and genetics is central to their understanding, and a very careful and thorough clinical approach is required to make a diagnosis. Tremendous advances in the basic sciences have allowed clinicians to understand and therefore manage patients with rheumatic diseases better.Pediatric RheumatologyRonald M. Laxer, David D. Sherry10.1016/j.pcl.2012.03.015Pediatric Clinics of North America 59, 2 (2012)2012-03-29Pediatric Clinics of North America2012-03-29592S0031-3955(11)X0008-1xiiixivhttp://www.pediatric.theclinics.com/article/PIIS0031395512000053/abstract?rss=yesThe immune system consists of 2 branches: innate and adaptive. The former represents the first line of host defense during infection and plays a key role in the early recognition and protection against invading pathogens. The latter orchestrates elimination of pathogens in the late phase of infection and leads to the generation of immunologic memory. Innate and adaptive immunity should not be considered separate compartments. Innate and adaptive immune responses represent an integrated system of host defense. The authors review the mechanisms driving the induction and perpetuation of the inflammatory responses observed during pathogen-associated, autoimmune, and autoinflammatory diseases.Principles of Inflammation for the PediatricianAlessia Omenetti, Sabrina Chiesa, Marco Gattorno10.1016/j.pcl.2012.03.004Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1225243http://www.pediatric.theclinics.com/article/PIIS0031395512000041/abstract?rss=yesArthritis is manifested as a swollen joint having at least 2 of the following conditions: limited range of motion, pain on movement, or warmth overlying the joint. This article discusses an approach to the evaluation of a child with arthritis of one (mono) or several (poly) joints.Approach to the Child with Joint InflammationRoberta Berard10.1016/j.pcl.2012.03.003Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1245262http://www.pediatric.theclinics.com/article/PIIS0031395512000090/abstract?rss=yesIn children, laboratory evaluations can assist in the screening of patients for inflammatory disorders, confirm diagnoses, allow for monitoring of disease activity and response to therapy, and suggest prognoses and risk of morbidities associated with rheumatic diseases. This review provides an overview of the usefulness and interpretation of both the commonly ordered tests ordered by the general pediatrician as well as those frequently used in the pediatric rheumatology clinic for diagnosis and disease monitoring. Studies discussed include the complete blood count, acute phase reactants, autoantibodies, serum complement, urinalysis, streptococcal antibody tests, and commonly used genetic studies.Laboratory Testing in Pediatric RheumatologyJay Mehta10.1016/j.pcl.2012.03.008Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1263284http://www.pediatric.theclinics.com/article/PIIS0031395512000028/abstract?rss=yesThis article presents five clinical scenarios in which the initial manifestations of pediatric rheumatic diseases constitute life-threatening medical emergencies. It is intended as a problem-oriented guide for pediatricians to assist in the recognition of rheumatologic differentials in children presenting with critical illness and provides an approach to their initial investigation and management.Rheumatologic Emergencies in Newborns, Children, and AdolescentsJonathan D. Akikusa10.1016/j.pcl.2012.03.001Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1285299http://www.pediatric.theclinics.com/article/PIIS0031395512000156/abstract?rss=yesJuvenile idiopathic arthritis (JIA) encompasses a complex group of disorders with arthritis as a common feature. This article provides the pediatrician with a review of the epidemiology, classification, clinical manifestations, and complications of JIA. It also provides an update on the current understanding of the cause of JIA and recent developments in management and a recent review of the long-term outcome in JIA.Juvenile Idiopathic ArthritisPeter J. Gowdie, Shirley M.L. Tse10.1016/j.pcl.2012.03.014Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1301327http://www.pediatric.theclinics.com/article/PIIS003139551200003X/abstract?rss=yesCytokine storm syndromes (CSS) are a group of disorders representing a variety of inflammatory causes. The clinical presentations of all CSS can be strikingly similar, creating diagnostic uncertainty. However, clinicians should avoid the temptation to treat all CSS equally, because their inciting inflammatory insults vary widely. Failure to identify and address this underlying trigger results in delayed, inoptimal, or potentially harmful consequences. This review places the hemophagocytic syndromes hemophagocytic lymphohistiocytosis and macrophage activation syndrome within a conceptual model of CSS and provides a logical framework for diagnosis and treatment of CSS of suspected rheumatic origin.Making Sense of the Cytokine Storm: A Conceptual Framework for Understanding, Diagnosing, and Treating Hemophagocytic SyndromesScott W. Canna, Edward M. Behrens10.1016/j.pcl.2012.03.002Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1329344http://www.pediatric.theclinics.com/article/PIIS0031395512000089/abstract?rss=yesSystemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of disease manifestations that can involve any organ system, and can lead to significant morbidity and even mortality. This article reviews the epidemiology, common clinical features, and complications of the disease, and briefly discusses the available treatment options. In addition, important medical and psychosocial issues relevant to the pediatrician caring for children and adolescents with SLE are discussed.Systemic Lupus Erythematosus in Children and AdolescentsDeborah M. Levy, Sylvia Kamphuis10.1016/j.pcl.2012.03.007Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1345364http://www.pediatric.theclinics.com/article/PIIS0031395512000077/abstract?rss=yesThe juvenile idiopathic inflammatory myopathies are a group of rare, chronic, multisystem, autoimmune diseases associated with muscle weakness. This article reviews practical issues of relevance to pediatricians, including clinical presentation, differential diagnosis, investigation, therapy, and prognosis. The importance of early recognition and specialist involvement is emphasized.Idiopathic Inflammatory Myopathies in Childhood: Current ConceptsAdam M. Huber10.1016/j.pcl.2012.03.006Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1365380http://www.pediatric.theclinics.com/article/PIIS0031395512000120/abstract?rss=yesPediatric scleroderma includes 2 major groups of clinical entities, systemic sclerosis (SSc) and localized scleroderma (LS). Although both share a common pathophysiology, their clinical manifestations differ. LS is typically confined to the skin and underlying subcutis, with up to a quarter of patients showing extracutaneous disease manifestations such as arthritis and uveitis. Vascular, cutaneous, gastrointestinal, pulmonary, and musculoskeletal involvement are most commonly seen in children with SSc. Treatment of both forms targets the active inflammatory stage and halts disease progression; however, progress needs to be made toward the development of more effective antifibrotic therapy to help reverse disease damage.Pediatric Scleroderma: Systemic or Localized FormsKathryn S. Torok10.1016/j.pcl.2012.03.011Pediatric Clinics of North America 59, 2 (2012)2012-04-09Pediatric Clinics of North America2012-04-09592S0031-3955(11)X0008-1381405http://www.pediatric.theclinics.com/article/PIIS0031395512000144/abstract?rss=yesChildhood vasculitis is a challenging and complex group of conditions that are multisystem in nature and often require integrated care from multiple subspecialties, including rheumatology, dermatology, cardiology, nephrology, neurology, and gastroenterology. Vasculitis is defined as the presence of inflammation in the blood vessel wall. The site of vessel involvement, size of the affected vessels, extent of vascular injury, and underlying pathology determine the disease phenotype and severity. This article explores the classification and general features of pediatric vasculitis, as well as the clinical presentation, diagnostic evaluation, and therapeutic options for the most common vasculitides.Pediatric VasculitisPamela F. Weiss10.1016/j.pcl.2012.03.013Pediatric Clinics of North America 59, 2 (2012)2012-04-09Pediatric Clinics of North America2012-04-09592S0031-3955(11)X0008-1407423http://www.pediatric.theclinics.com/article/PIIS0031395512000107/abstract?rss=yesKawasaki disease is a systemic vasculitis and the leading cause of acquired heart disease in North American and Japanese children. The epidemiology, cause, and clinical characteristics of this disease are reviewed. The diagnostic challenge of Kawasaki disease and its implications for coronary artery outcomes are discussed, as are the recommended treatment, ongoing treatment controversies, concerns associated with treatment resistance, and the importance of ongoing follow up.Kawasaki DiseaseRosie Scuccimarri10.1016/j.pcl.2012.03.009Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1425445http://www.pediatric.theclinics.com/article/PIIS0031395512000065/abstract?rss=yesThere has been an expansion of the autoinflammatory syndromes due to the discovery of new diseases related to mutations in genes regulating the innate immune system and the knowledge gained from these diseases as applied to more common nongenetic inflammatory conditions. Autoinflammatory syndromes are characterized by unprovoked (or triggered by minor events) recurrent episodes of systemic inflammation involving various body systems, which are often accompanied by fever. Inflammation is mediated by polymorphonuclear and macrophage cells through cytokines, particularly interleukin-1. This article reviews the clinical approach to patients with suspected autoinflammatory syndromes, several of the main and new (mostly genetics) syndromes, advances in treatment, and prognosis.Autoinflammatory SyndromesPhilip J. Hashkes, Ori Toker10.1016/j.pcl.2012.03.005Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1447470http://www.pediatric.theclinics.com/article/PIIS0031395512000132/abstract?rss=yesMusculoskeletal pain is one of the most common presenting symptoms at the pediatrician's office. Etiology ranges from benign conditions to serious ones requiring prompt attention. This article addresses entities that present as musculoskeletal pain but are not associated with arthritis. The most common nonarthritic conditions are benign limb pain of childhood (growing pains), hypermobility, overuse syndromes with or without skeletal abnormalities, malignancies, and pain amplification syndromes. The| initial decision process, diagnosis, and treatment options for each of these conditions are discussed.Approach to the Patient with Noninflammatory Musculoskeletal PainPeter Weiser10.1016/j.pcl.2012.03.012Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1471492http://www.pediatric.theclinics.com/article/PIIS0031395512000119/abstract?rss=yesMost clinicians associate primary immunodeficiency disorders (PIDDs) with susceptibility to frequent or severe infections. It is less commonly recognized, however, that PIDDs are frequently associated with autoimmune or rheumatologic manifestations. This review provides a synopsis of the rheumatic manifestations associated with immunodeficiencies in each of the major compartments of the immune system.Immunodeficiency Diseases with Rheumatic ManifestationsTroy R. Torgerson10.1016/j.pcl.2012.03.010Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1493507http://www.pediatric.theclinics.com/article/PIIS0031395512000387/abstract?rss=yesIndex10.1016/S0031-3955(12)00038-7Pediatric Clinics of North America 59, 2 (2012)2012-04-01Pediatric Clinics of North America2012-04-01592S0031-3955(11)X0008-1509531