Diagnosis and conservative treatment of juvenile rheumatoid arthritis

About the department

The Department of Pediatric Pulmonology, Allergology and Rheumatology at the Hannover Medical School offers comprehensive diagnostics and effective treatment of acute and chronic diseases of the lungs and respiratory tract, allergic reactions and rheumatic diseases. With the Department of Gynecology and Obstetrics, the department forms the Level I Perinatal Center, and therefore young patients of all age groups, including newborns and premature babies, can receive high-quality medical care here. The department's medical team specializes in conservative treatment, and if surgery is required, pediatric surgeons are involved in the process. In addition to specialized doctors, the department employs an experienced team of nursing staff, psychologists, nutritionists, physiotherapists and other specialists whose task is to restore the child's health. The doctors devote enough time to communication with children and their parents, and also do everything possible to make the child feel as comfortable as possible in the hospital. The Chief Physician of the department is Prof. Dr. med. Gesine Hansen.

One of the main focuses of the department's clinical activities is the provision of medical care to children with diseases of the lungs and respiratory tract. Depending on the particular clinical case, children with pathologies of this spectrum can receive treatment both on an inpatient or outpatient basis. The department has well-equipped diagnostic rooms, which allow pediatric pulmonologists to assess the condition of the child's lungs and respiratory tract. The department's diagnostic options include whole-body plethysmography, spirometry, impulse oscillometry, lung diffusion testing, treadmill exercise stress tests, laryngoscopy, provocation tests, and other diagnostic methods. With diagnostic results, the attending physician makes a diagnosis and begins to develop an optimal treatment regimen. The department carries out only conservative therapy, which consists in the intake of drugs. If drug therapy does not yield the desired result, it becomes necessary to use more radical therapeutic measures. Pulmonologusts plan endoscopic or surgical treatment in collaboration with pediatric surgeons, thoracic surgeons, radiologists and other specialists. Pediatric pulmonologists most often admit young patients with severe forms of bronchial asthma, congenital malformations of the lungs and respiratory tract, interstitial lung diseases, infectious respiratory diseases, etc.

The department includes a specialized Pediatric Cystic Fibrosis Center, which began its work in 1972 and today is known as one of the best specialized centers in Germany. Moreover, as of today, it is the only medical facility in the country where young patients can receive the full range of diagnostic and therapeutic procedures – from genetic tests, sweat tests and electrophysiological tests to lung transplant. The doctors of the center annually treat about 2,000 children under the age of 18, who suffer from cystic fibrosis and similar severe lung diseases.

An integral part of the work of the medical facility is the diagnostics and treatment of allergies in children. Pediatric allergists specialize in the treatment of bronchial asthma, allergic rhinitis, food allergies, atopic eczema, insect venom allergies, and drug allergies. Allergies are detected using skin tests, IgE tests, nasal provocation tests, and special provocation tests to determine food intolerances. The main treatment method for allergy is allergen-specific immunotherapy (hyposensitization, ASIT). In most cases, children with allergies receive medical care on an outpatient basis. Hospitalization may be required if the child develops wasp or bee venom allergy.  

The department also employs a competent team of pediatric rheumatologists, who annually admit more than 1,400 children with pathologies of this spectrum. The department belongs to the largest medical facilities in Germany specializing in rheumatic diseases in children. The department's interdisciplinary team, consisting of pediatric rheumatologists, nurses, physiotherapists, psychologists and social teachers, carries out diagnostics and treatment of all rheumatic diseases in children under the age of 18. The most common clinical conditions include all forms of juvenile rheumatoid arthritis, including systemic arthritis, enthesitis-related arthritis, psoriatic arthritis, and all forms of scleroderma. The diagnostic options include standardized assessment of joint status and muscle examination (assessment of myositis in children, manual muscle testing), as well as imaging diagnostics (ultrasound, MRI, etc.). In addition to drug therapy, the department carries out joint punctures, steroid injections, as well as splints and individual selection of other aids.

The department's range of medical services includes:

• Diagnostics and treatment of pulmonary diseases
  • Bronchial asthma
  • Chronic obstructive pulmonary disease
  • Acute and chronic infectious diseases of the lungs
  • Pulmonary tuberculosis
  • Interstitial lung diseases (ILD)
  • Primary ciliary dyskinesia (PCD)
  • Bronchopulmonary dysplasia
  • Congenital pathologies of the respiratory tract
  • Extrinsic allergic alveolitis
  • Allergic bronchopulmonary aspergillosis
  • Bronchiectasis
  • Malformations and diseases of the pulmonary vessels
  • Alpha-1-antitrypsin deficiency (including cystic fibrosis)
  • Breathing dysregulation
  • Systemic diseases involving the respiratory tract
• Diagnostics and treatment of allergic diseases
  • Bronchial asthma
  • Allergic rhinitis
  • Food allergies
  • Atopic eczema
  • Insect venom allergy
  • Drug allergy
• Diagnostics and treatment of rheumatic diseases
  • All forms of juvenile arthritis
    • Oligoarthritis
    • Seronegative and seropositive polyarthritis
    • Still's disease
    • Enthesitis-related arthritis
    • Psoriatic arthritis
  • Collagenoses
  • Systemic lupus erythematosus
  • Juvenile dermatomyositis
  • All forms of scleroderma
    • Sclerodermia placata
    • Linear scleroderma
    • Systemic scleroderma
    • Vasculitis (Kawasaki disease, Henoch-Schonlein purpura and others)
    • Periodic fever syndromes (familial Mediterranean fever, TRAPS, and others)
    • Chronic nonbacterial osteomyelitis
• Other diagnostic and therapeutic options