In the last year, forever famous for the pandemic, we’ve learned a great deal about the immune system. The immune system is the body’s natural defense against outside invaders. It’s a complex network of cells, organs and molecules that fight against things like viruses and bacteria, even pollen.

It’s a powerful protection, and we couldn’t survive without it. It can, however, turn against us in what’s called an autoimmune disease (auto meaning “self” so immune to self).

Part of the normal process of protection is a targeted defense that identifies the invader and makes unique proteins (antibodies) to mark the invader for attack. There are special white blood cells called B cells that produce the antibodies and T cells, which coordinate and carry out the attack. Most important are T cells that signal stopping the attack.

In autoimmune diseases, the immune system mistakenly begins attacking healthy cells and tissues and fails to shut off the attack. Autoimmune diseases are rare in children, but they do occur and can be difficult to diagnose and to treat. More than 80 autoimmune diseases have been diagnosed and can affect almost any part of the body, skin, muscle and joints, intestines and even the brain.

In general, autoimmune diseases often fall into one of two groups: Organ-specific disorders, which focus on one organ or specific type of tissue such as Addison’s disease (adrenal glands), Crohn’s or celiac disease (intestines), multiple sclerosis (CNS), type 1 diabetes (pancreas); non-organ-specific disorders such as lupus (joints, skin, liver, kidneys, heart, brain); or scleroderma (skin, joints, intestines, lungs).

Researchers have found certain risk factors for autoimmune disease.

• Vaccinations are not a risk.

• Girls are almost three times more likely than boys to have an autoimmune disease.

• Most autoimmune diseases affect younger and middle-age people, and some are specific to childhood such as juvenile idiopathic arthritis.

• A family history of autoimmune disease puts a child at higher risk.

• African-American children are more likely to develop lupus and scleroderma, while Caucasian children are more likely to develop multiple sclerosis.

As autoimmune diseases can affect almost any part of the body, their symptoms are varied and related to the organs being attacked. Symptoms can range from fatigue and mild rashes to serious side effects like seizures. These symptoms can come and go and are non-specific.

Treatments depend on which part of the body is involved and is usually either replacement therapy and/or anti-inflammatory therapy. As information is determined about exactly which part of the body the immune system is attacking, specific treatments are used.

In celiac disease, the body’s immune system mounts an attack against the “invasion” of gluten, the reaction damages the villi (slight hair-like projections that line the small intestines). This damage prevents the villi of their function of absorbing vitamins, minerals and other nutrients, causing chronic inflammation and malabsorption. This results in poor growth and malnutrition. By avoiding gluten, the villi are spared, and symptoms are gone.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.

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