Paediatric Rheumatology Unit

The Paediatric Rheumatology Unit has always been a centre of reference within our Rheumatology Department. We have a close relationship with other paediatric units with the aim of setting up common strategies for diagnosing, treating and monitoring our patients.

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Some of the conditions that we diagnose, monitor or treat most frequently are:

• Juvenile idiopathic arthritis.
   
• Systemic lupus erythematosus (LES).
   
• Juvenile Dermatomyositis (DMJ).
  

• Autoinflammatory disorders such as periodic fever syndrome, aphtas, pharyngitis and adenitis (PFAPA), familial Mediterranean fever (FMF), TNF receptor-associated periodic syndrome (TRAPS) and hyper-IgD syndrome or periodic fever/mevalonate kinase deficit (HIDS/MVDK), cryopyrin-associated periodic syndromes (CAPS) and Blau’s syndrome, amongst others.
   
• Juvenile onset systemic scleroderma.
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• Localised scleroderma.
  

• Mixed connective tissue disease (MCTD).
   
• Juvenile onset Sjögren's syndrome.
   
• Large vessel vasculitis, such as Takayasu's arteritis.
   
• Medium vessel vasculitis, such as panarteritis nodosa or Kawasaki disease.
   
• Small vessel vasculitis, such as granulomatisis with polyangitis, eosinophyllic granulomatosis with polyangitis and Schönlein-Henoch purpura.
   
• Paediatric onset Behçet's disease.
   
• Bone metabolism diseases, such as juvenile osteoporosis due to secondary causes and osteogenesis imperfecta.
   
• Pain amplification syndromes.
  

• Non-infectious uveitis (in collaboration with Paediatric Ophthalmology).


Portfolio of Services

• Outpatient Appointments (General Hospital, Traumatology and Mother/Child) structured along various highly specialised care lines:
  • Juvenile Idiopathic Arthritis clinic (JIA): This is a benchmark Spanish clinic with a long history of regular, documented monitoring of patients with JIA. The doctors in charge of this clinic have extensive, recognised experience in assessing, monitoring and treating these patients.
  • Paediatric Systemic Autoimmune Diseases Clinic: This clinic treats more than 100 paediatric patients with SAD (e.g., systemic lupus erythematosus, vasculitis and scleroderma, etc) who are regularly monitored and documented, which means that the unit positions itself as a highly experienced Unit in this disease group.
  • Transition Clinic: This clinic assesses young adult patients, referred from paediatric rheumatology clinics. It is one of the first transition clinics to be rolled out in this area nationally and is designed for the purpose of facilitating the transition from paediatric to adult care.
  • Paediatric Autoinflammatory Diseases Clinic: Autoinflammatory diseases are rare and, due to their high complexity, require monitoring in specific units in tertiary-level hospitals where multidisciplinary assessment and treatment is carried out. Our structure and experience enable continuous monitoring of these patients throughout their lives.
  • Paediatric Central Sensitisation Syndromes Clinic
  • Paediatric Techniques and Ultrasound Department: The Paediatric Rheumatology department carries out joint ultrasounds, infiltrations and ultrasound-guided arthrocentesis, or with the patients being monitored under sedation, at PRU outpatient appointments.
• Consultations and Hospitalisation (Children’s Hospital and Women’s Hospital): The PRU doctors assess the patients admitted to the Paediatric Department with juvenile rheumatic diseases, or any other disease, and who show locomotive system symptoms while they are admitted. They also carry out the consultations coming from the Emergency Department, the Paediatric Intensive Care Unit and outpatient appointments for other paediatric specialities.
• Day Hospital (Children’s and Women’s Hospital) where intravenous treatments are given (biotechnology pharmaceuticals, immunoglobulins and bisphosphonates, etc).
• Second opinion consultations
• On-line appointments: We work to offer patients and their families a continuous communication route with the professionals in the Unit with video consultations, replies to queries by e-mail and telephone appointments.

Research

The PRU takes part in a multitude of research and clinical trials. All of them are approved beforehand by the hospital’s Ethics Committee (CEIm). The main lines of research are directed at the application of new techniques and procedures that, in the short, medium and long term, allow us to improve diagnosis and treatment of particular diseases.

Internationally, the PRU takes active part in European studies lead by the PRINTO (Paediatric Rheumatology International Trials Organisation) and the Paediatric Rheumatology European Society (PRES). It actively collaborates in the European Pharmachild project on pharmacovigilance funded by the European Union. Furthermore, due to a long standing record in knowledge about and classification of autoinflammatory syndromes, it actively collaborates with the European EUROFEVER organisation.

Education

Rheumatology resident doctors do a 4 month turn in the Paediatric Rheumatology Unit and Paediatrics residents have the chance to do a turn at the Unit. The basic aim of training in this period is to get to know about handling the actual processes of our speciality.  Apart from the hospital's residents, the PRU also frequently receives resident doctors from Paediatrics and Rheumatology at other hospitals, both in Spain and abroad.