Curing Kiarah: A severe case of pneumonia leads to lupus diagnosis

During Kiarah's stay in the hospital, Margaret (right) said she couldn't imagine taking her anywhere else.

During Kiarah’s stay in the hospital, Margaret (right) said she couldn’t imagine taking her anywhere else.

There’s a quiet calmness that surrounds 13-year-old Kiarah Harris. It envelopes you the moment you meet her.

However, last year, Kiarah’s life was anything but calm as she fought a life-threatening case of pneumonia at Akron Children’s Hospital. It was during this time that doctors diagnosed her with a chronic, auto-immune disorder.

A complicated case

In the fall of 2012, Margaret Harris heard her daughter call out to her in the hallway of their Youngstown home.

“She was extremely dizzy, holding onto the wall for support,” said Margaret. “I took her to the hospital right away, and they found out she had pneumonia.”

Doctors placed Kiarah on antibiotics, and for nearly 3 months, she and Margaret made frequent trips to their pediatrician to monitor her condition.

Kiarah relies on the support of her siblings (from left) Tia and Abdul, her mother and sister Ashanti.

Kiarah relies on the support of her siblings (from left) Tia and Abdul, her mom and sister Ashanti.

But Kiarah wasn’t improving. An X-ray revealed that the fluid had not only remained in her left lung, but collected in her right lung as well.

Margaret and Kiarah soon found themselves at Akron Children’s Beeghly campus, where doctors determined that Kiarah needed surgery at the hospital’s campus in Akron. There, surgeons would insert chest tubes to drain the fluid from her lungs.

After surgery, nearly 2 quarts of fluid was drained from Kiarah’s right lung while her left lung contained between a half and a full quart of fluid.

It was a stressful time for the Harris family. Throughout her illness, Kiarah had lost 12 lbs., and she still wasn’t feeling well after surgery.

Dr. Mary Toth

Dr. Mary Toth

“She wasn’t progressing as she should have,” said Dr. Mary Bratovich Toth, director of pediatric rheumatology at Akron Children’s Hospital. “She wasn’t exhibiting the recovery signs that a typical pneumonia patient would show.”

Kiarah also has autism, which makes it difficult for her to communicate when she isn’t feeling well.

One day, Margaret’s sister Christine asked Kiarah if something hurt.

“Yes,” came her small reply.

When Christine asked Kiarah to show her where it hurt, she pointed to her chest.

Christine immediately called in members of the medical team, and an X-ray revealed there was fluid around Kiarah’s heart.

An unexpected diagnosis

“Since her verbal skills aren’t like that of other children, it was difficult to find the symptoms we typically use to clue us in on a diagnosis. It took deductive detective work to figure out what was going on.” – Dr. Toth

During an emergency procedure, surgeons inserted a tube to drain the fluid around Kiarah’s heart, resulting in a 5-day stay in Akron Children’s pediatric ICU.
While her doctors expected her health to improve, Kiarah began to spike fevers. The antibiotics also began affecting her kidney function.

Doctors from multiple divisions were called in to consult on her case, including nephrology, cardiology and rheumatology.

A biopsy of Kiarah’s lung tissue showed no sign of cancer or fungal infection. However, a re-inserted chest tube showed that she still had drainage in her lungs.

“While the fluid was draining, the fluid production wasn’t decreasing. That made us believe that something else, like an auto-immune disorder, was to blame,” Dr. Toth said. “Since her verbal skills aren’t like that of other children, it was difficult to find the symptoms we typically use to clue us in on a diagnosis. It took deductive detective work to figure out what was going on.”

Finally, Dr. Toth and the rest of the medical team diagnosed Kiarah with lupus.

“Lupus is a chronic, auto-immune disorder that affects skin, joints, kidneys and other organs,” said Dr. Toth. “On average, I see 4 to 5 patients a year with the condition. It can be difficult to diagnose because it can look like something else, mimicking conditions like infections and arthritis.”

Dr. Toth placed Kiarah on a steroid regimen to control the inflammation in her lungs.

Throughout the ordeal, Margaret was comforted by the support of the hospital.

“With my family being in Youngstown, Christine stayed with Kiarah the entire time she was in the hospital,” Margaret said. “Akron Children’s provided meals for Christine and gave me gas cards for all the trips I made back and forth. They found out that Kiarah loves computers so they loaned her one during her admission so she could watch her favorite shows. It really helped make our time there a lot easier.”

A strong recovery

Throughout her stay, Dr. Toth marveled at how well Kiarah handled her time in the hospital.

“She was always pleasant and cooperative,” Dr. Toth said. “She never once complained, even during the hardest times.”

It’s a demeanor she maintains today as she continues to recover. The fluid around her heart has cleared, and she gained back the weight she lost.

Physical therapy helped her regain her strength after being in a hospital bed for an extended period, and she’s slowly coming off her steroid regimen, visiting Dr. Toth every 2 weeks.

kiarah-on-computer-with-sibMargaret remains grateful to the hospital for how well the staff took care of her and her family during Kiarah’s stay.

“They’re so caring. They want to make sure you and your child receive the best care possible,” she said. “They took the time to explain things to me and answer any and all questions. Under the circumstances, it was a nice place to be. I couldn’t imagine taking her anywhere else.”

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