Paediatric Rheumatology and Immunology KIMS Cuddles at KIMS Hospital, Mahadevapura, Bengaluru

A child with joint pain that will not settle, a fever that keeps coming back without a clear source, a rash that appears and disappears unpredictably, or an infection history that seems more frequent and more severe than it should be, these are the presentations that bring families to a paediatric rheumatology and immunology specialist. They are also the presentations that most commonly go undiagnosed for months, or are attributed to growing pains, viral illness, or bad luck, while an underlying condition continues without appropriate management.

The Paediatric Rheumatology and Immunology service at KIMS Cuddles at KIMS Hospital, Mahadevapura provides specialist assessment and management of conditions where a child's immune system is either overreacting and damaging the child's own tissues, or failing to respond adequately and leaving the child vulnerable to infections. Both ends of this spectrum require expertise, careful investigation, and long-term management that accounts for the child's growth and development throughout.

Two Distinct but Related Specialties

Paediatric rheumatology focuses on inflammatory and autoimmune conditions that affect the joints, muscles, connective tissues, and other organ systems. The immune system, which is designed to protect the body from infection, mistakenly attacks the body's own tissues, causing chronic inflammation and damage.

Paediatric immunology focuses on children whose immune systems are underperforming, either because of a genetic deficiency in one or more components of immune function, or because of an acquired condition that has compromised immune responses. These children experience recurrent, unusually severe, or opportunistic infections that would not affect children with normal immune function.

The two fields overlap significantly in clinical practice, and many children who present with immune dysregulation have features of both. Our team at KIMS Cuddles at KIMS Hospital, Mahadevapura is trained across both domains, providing unified care rather than fragmented management.

Rheumatological Conditions We Manage

Juvenile idiopathic arthritis

Juvenile idiopathic arthritis is the most common rheumatic disease in childhood, encompassing several subtypes that differ in the number of joints affected, the presence of systemic features, and the long-term prognosis. Children with juvenile idiopathic arthritis experience joint swelling, pain, stiffness, and in some subtypes, fever, rash, and involvement of organs including the eyes, liver, and heart. Early diagnosis and appropriate treatment with disease-modifying agents reduces the risk of joint damage and long-term disability.

Systemic lupus erythematosus

Lupus in children is often more severe than adult-onset disease and affects a wider range of organ systems including the kidneys, brain, skin, and blood. Our team manages childhood lupus with the structured monitoring and treatment protocols that this complex condition requires, with close attention to the impact of long-term immunosuppressive therapy on a growing child.

Kawasaki disease

Kawasaki disease is an acute vasculitis that primarily affects the coronary arteries and requires prompt diagnosis and treatment to prevent coronary artery aneurysms. Our team manages the acute phase in coordination with paediatric cardiology and provides structured long-term follow-up for children with coronary involvement.

Vasculitis

Vasculitis encompasses a range of conditions where blood vessel inflammation causes damage to tissues and organs. IgA vasculitis, formerly known as Henoch-Schonlein purpura, is the most common childhood vasculitis and typically presents with a characteristic rash, joint pain, abdominal pain, and kidney involvement. Rarer forms of vasculitis require specialist investigation and management.

Periodic fever syndromes

Children with periodic fever syndromes experience regular episodes of fever, often accompanied by other symptoms including mouth ulcers, lymph node swelling, and abdominal pain, that occur in a recognisable pattern and resolve between episodes. These conditions are caused by dysregulation of the inflammatory response and require specialist assessment to identify the specific syndrome and guide appropriate management.

Dermatomyositis and myositis

Inflammatory muscle disease in children presents with gradual muscle weakness, distinctive skin rashes, and occasionally other organ systems. If diagnosed early and with adequate immunosuppressive therapy the likelihood of long-term muscle injury reduces. 

Scleroderma

Scleroderma in children involves abnormal collagen deposition. This depositions leads to skin thickening and tightening. The management deals with coordination across rheumatology, dermatology, and the relevant organ-specific subspecialties.

Immunological Conditions We Manage

Primary immunodeficiency disorders

Children with primary immunodeficiency have genetic defects in one or more components of immune function. This makes them vulnerable to recurrent and severe infections. The range of conditions is broad, from common variable immunodeficiency and selective IgA deficiency to severe combined immunodeficiency and more complex genetic immune disorders. Diagnosis requires specific immunological testing, and management ranges from immunoglobulin replacement therapy to haematopoietic stem cell transplantation in the most severe cases.

Recurrent infections suggesting immune dysfunction

A child who has had more than eight ear infections in a year, more than two serious infections such as pneumonia or meningitis, or infections caused by unusual organisms should be assessed for an underlying immunodeficiency. Our team uses a systematic approach to immunological investigation to identify whether an immune deficiency is present and determine the most appropriate management.

Secondary immunodeficiency

Children on long-term immunosuppressive therapy for autoimmune or inflammatory conditions, those with haematological malignancies, and those who have undergone organ transplantation are all at risk of secondary immune dysfunction. Our team manages the immunological aspects of care for these children in coordination with the relevant subspecialties.

Autoinflammatory diseases

Autoinflammatory conditions, where abnormal activation of the innate immune system causes recurrent episodes of inflammation without the autoantibodies seen in autoimmune disease, are an increasingly recognised category of paediatric immune disorders. Our team has expertise in diagnosing and managing these complex conditions.

How We Approach Diagnosis

Conditions in paediatric rheumatology and immunology are often complex and need systematic investigation. Our team makes use of a structured assessment process covering:

• Detailed clinical history including the pattern of symptoms, family history, and infection history
• Targeted laboratory investigations including inflammatory markers, autoimmune antibody panels, complement levels, and full immunological profiling where indicated
• Imaging that includes joint ultrasound, MRI of joints that are affected, and organ imaging in the case of systemic disease
• Specialist ophthalmological assessment for children with juvenile idiopathic arthritis, where asymptomatic uveitis is a significant complication requiring regular screening

Why Choose KIMS Cuddles at KIMS Hospital, Mahadevapura

Managing childhood autoimmune and immune deficiency conditions requires a team with specific expertise, access to advanced laboratory investigations, and the ability to coordinate with multiple subspecialties when systemic disease affects several organ systems simultaneously. At KIMS Cuddles at KIMS Hospital, Mahadevapura, our rheumatology and immunology team works within a fully integrated children's hospital, with immediate access to nephrology, cardiology, ophthalmology, haematology, and the paediatric intensive care team for complex and critically ill children.

For families in East Bengaluru, Whitefield, and Marathahalli, having specialist paediatric rheumatology and immunology care close to home makes the regular monitoring and follow-up that these long-term conditions require considerably more manageable.

Book a Consultation

If your child has unexplained joint pain, recurrent fever, an unusual pattern of infections, or has been referred for rheumatology or immunology assessment, our team at KIMS Cuddles at KIMS Hospital, Mahadevapura is here to help. Book an appointment online or by phone.