Conditions + Treatments

Treatments for Vasculitis in Children

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It's understandable that you may feel upset or frightened to hear your child has vasculitis. But at Children's, we view the diagnosis as a starting point: Having identified your child's condition, we're able to begin the process of treating him so that we may ultimately return him to good health.

In some children, certain forms of vasculitis will improve on their own -- for instance, Henoch-Schönlein purpura may run its course in four to six weeks with no treatment beyond bed rest, plenty of fluids and, occasionally, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. But other children will need medications to control their vasculitis and head off or treat serious complications.

Medications commonly used to treat vasculitis include:

  • Corticosteroids -- often prednisone -- are not the same as the anabolic steroids that athletes sometimes take. These are extremely powerful, fast-acting drugs that fight inflammation by suppressing the entire immune system. However, doctors work to phase them out as soon as possible because of their potential side effects, which can include high blood pressure and reduced bone density.
  • Steroid-sparing immunosuppressants offer many of the benefits of corticosteroids -- and sometimes with fewer side effects -- but take longer to work. The most powerful of this group is cyclophosphamide (Cytoxan); others include azathioprine (Imuran); methotrexate;and mycophenolate mofetil, or MMF (CellCept).
  • Biologics are a relatively new class of steroid-sparing therapies based on compounds made by living cells. Instead of suppressing the entire immune system, biologics are more like smart bombs -- they only target certain parts of it. Biologics now being used for vasculitis include tumor necrosis factor (TNF) blockers such as infliximab (Remicade). Side effects vary by medication, but are generally milder than with other kinds of steroid-sparing therapies.
     

Children with some kinds of vasculitis -- particularly Kawasaki disease -- may also benefit from IVIg (intravenous immunoglobulin).This is a blood product made up of healthful antibodies that is delivered by IV, and can help get the immune system back on track without suppressing its normal function.

In rare instances, children with vasculitis will develop complications that require surgery -- for instance, if an abnormal bulge (aneurysm) develops in a blood vessel wall, doctors may need to operate to keep it from rupturing.
 

Coping and support

We understand that you may have a lot of questions when your child is diagnosed with vasculitis. How will it affect my child's life? What do we do next? We've tried to provide some answers to those questions here, but there are also a number of other resources to help you and your family in dealing with your child's unique illness, such as:

  • Parent-to-parent connections: Want to talk with someone whose son or daughter has faced the same kind of vasculitis as your child? A number of Children's parents volunteer for special training to help the families of newly diagnosed kids. Alternatively, your child's doctor may be able to put you in touch with a mom or dad of another patient who can share their experiences with you.
  • Social work: Our Rheumatology Department includes social workers -- in both inpatient and outpatient settings -- who have assisted many other families whose children have vasculitis. Your social worker can offer counseling and problem-solving advice on issues such as coping with your child's diagnosis; dealing with financial difficulties; and finding temporary housing near the hospital if your family is traveling to Boston from another area.
  • Coping Clinic: This program has an experienced team of pediatric psychologists, psychiatrists and other mental health professionals to help children and families deal with any extra stress that vasculitis may bring. Offering evaluations, short-term therapy and family counseling, the Coping Clinic staff can teach you ways to prevent or better deal with the challenges of long-term illness.
     

In addition, there are many groups that help connect and educate people across the country who have vasculitis. Your doctor may be able to recommend which ones are best for your child's specific kind of vasculitis, but a good place to start is the Vasculitis Foundation (www.vasculitisfoundation.org), an international nonprofit with over 4,000 members in 58 countries. The group provides educational materials on all kinds of vasculitis, as well as contact information for local support groups. The foundation also encourages and supports research into the cause, cure and treatment of vasculitis.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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