Does your baby often have a fever for no reason? Let's talk about these SAIDs (Systemic Autoinflammatory Diseases)

Does your little one just get a fever all the time? Does he get better after a fever for a few days, only to get another fever a few days later? You might be wondering why this happens without a virus or bacterial infection. This could be due to a rare condition called SAIDs (Systemic Autoinflammatory Diseases) , which many people have not heard of. Don't worry, let's talk about it in simple terms and understand everything.

What are SAIDs? Let's understand it simply.

Simply put, SAIDs are a group of diseases that cause frequent, recurring fevers without any infection (such as viruses or bacteria). The cause of this is a malfunction in our child's innate immune system . This was previously called 'Periodic Fever Syndromes'.

Now you may be wondering, is this an 'autoimmune' disease? We often hear about autoimmune diseases like Rheumatoid Arthritis or Lupus. No, this is different.

Imagine that we have a defense army inside our body, our immune system. This army has two main parts:

1. Innate Immune System: This is the army that we are born with, and is the first to attack any germ.

2. Adaptive Immune System: This is an army that is specially trained to fight off various germs as we grow up.

In SAIDs, the problem is with the innate immune system . That immune system gets agitated and starts a fight within the body without any enemy. The result of this fight is inflammation in the body and a fever.

But in the autoimmune diseases we talked about, the problem is with the adaptive army that is trained later. That army is unable to recognize the good cells in its own body and starts attacking them.

SAIDs are much rarer than autoimmune diseases. They are often caused by genetic causes, meaning they are inherited. These symptoms usually begin when a child is very young, such as during infancy or toddlerhood. The child suddenly has an episode or attack of illness with fever and other symptoms, which usually resolves within a few days. The child may be completely healthy when not sick. Although there is no cure, there are effective treatments that can control the symptoms.

What are the main types of SAIDs?

Researchers have identified about 60 types of SAIDs so far, and new types are being discovered all the time. Here are some of the most common types.

What are the common symptoms of these diseases?

The main and most common symptom of SAIDs is recurrent fever . However, in addition to fever, other symptoms may also occur depending on the type of disease.

Why do these diseases occur? What are the causes?

As we mentioned earlier, many SAIDs are genetic diseases . This means that these diseases are caused by a mutation (variant) in a particular gene.

What can happen if proper treatment is not received?

This is a very important issue. It is essential to control this condition by taking proper treatment. Because, if there is continuous inflammation in the body like this, it can lead to a condition called Amyloidosis . Simply put, a type of protein can be deposited in our kidneys, causing permanent damage to the kidneys. Therefore, it is very important to diagnose the disease and treat it quickly.

How does a doctor diagnose this disease?

To be honest, diagnosing SAIDs can be a bit challenging because the symptoms can be similar to those of other serious diseases, such as lupus.

Therefore, the most important thing is to see a doctor who specializes in these types of diseases. A doctor who specializes in diseases related to the joints and the immune system is called a Rheumatologist .

Your doctor will consider several factors to make a diagnosis. He or she will likely ask about your child's symptoms and whether there is a family history of the condition. Your doctor may suspect SAIDs, especially if:

• If the child has frequent fevers.
• If anyone in the family has had recurring flu-like illnesses like this.
• Since these diseases are common among some ethnic groups, that is also being considered.

What tests are performed?

The doctor may recommend several tests to confirm the disease.

• Blood tests (Lab tests): Tests like C-reactive protein (CRP) and CBC (Full Blood Count) can check for inflammation in the body. These levels increase during illness and return to normal levels when the body is well.
• Urine test: Checks for elevated protein levels in the urine. In some diseases, such as MKD, urine tests can detect specific acids.
• Genetic testing: This test can detect genetic mutations. However, sometimes, a child may have SAID but the genetic test may not detect it. Therefore, even if the test result is negative, it cannot be said 100% that the disease is not present.

What are the treatments for this?

Treatment for SAIDs depends on the type and severity of the disease. Although these diseases cannot be completely cured, medications can greatly control the symptoms.

• FMF: A drug called Colchicine is used for this. It reduces inflammation in the body. If that drug doesn't work for the child, they can turn to drugs like Canakinumab .
• PFAPA: Steroids like Prednisone can be given for a short period of time to quickly reduce the duration of the illness.
• TRAPS: The drug Canakinumab is very effective. Also, anti-inflammatory drugs like Glucocorticoids are used.
• MKD: The drug Canakinumab is effective for this as well. NSAIDs (painkillers) or steroids can help during illness.
• NLRP3 Diseases: Immune-modifying drugs such as Canakinumab , Rilonacept , and Anakinra are used successfully for this.
• Blau Syndrome: Depending on the symptoms, immunosuppressants, TNF inhibitors, and eye medications may be used.

Will this condition be completely cured?

Some SAIDs are lifelong. However, some, like PFAPA, may go away on their own as the child grows older. Even though they are lifelong conditions, the frequency of illness and the severity of symptoms may decrease over time. Your doctor will give you specific details about your child's condition.

Caring for a child with this condition can be challenging. But with the help of the right specialists, you can manage your child's symptoms and give them the best childhood possible.

Fever, fever in children, SAIDs, periodic fever syndrome, autoinflammatory disease, genetic diseases, immune system