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NIH Marks Opening of Pediatric Rheumatology Clinic

By Janet Howard

NIH has opened its first pediatric rheumatology clinic at the Clinical Center. A reception was held recently to mark the clinic's establishment.

Organized by NIAMS, the specialty clinic offers diagnosis, evaluation and treatment for children with arthritis and other chronic rheumatic diseases. It also serves as a specialty care facility for children through age 17 who are suspected of having, or have a confirmed diagnosis of a rheumatic disease.

NIAMS scientific director Dr. Peter Lipsky chaired the reception. "This project represents a coming together of the community and the Clinical Center," he said. "Thanks to all who were involved in developing this clinic. The clinic will help scientists gather research data we so badly need, especially since rheumatic diseases in children vary considerably from those in adults."

Helping to launch the new pediatric rheumatology clinic are (from l) KaLea Kunkle, who has pediatric scleroderma; Renee Thomas, chair, American Juvenile Arthritis Organization; NIAMS pediatrician and clinic staffer Dr. Raphaela Goldbach-Mansky; NIAMS scientific director Dr. Peter Lipsky; and clinic codirector Dr. Robert Lipnick.

The youngest speaker at the reception, KaLea Kunkel, 16, from Oregon, MO, has juvenile scleroderma. She, like her three siblings, has a rheumatic disease. "I am here representing the more than 300,000 kids with a rheumatic disease, which may be invisible to the outsider," she said. "But the truth is that these irreversible diseases affect every aspect of a child's life."

Other speakers included KaLea's mother, Ann Kunkel, who also has a rheumatic disease, and is an advocate for the American Juvenile Arthritis Organization (AJAO). Renee Thomas, AJAO chair, presented an award to Lipsky and NIAMS for ongoing work in juvenile rheumatic diseases. "This is a wonderful celebration," she noted. "Children walking through these doors will be very fortunate. Working together, we can make the dream come true to eventually cure our children who have arthritis."

Nurse Janet Jones was instrumental in helping establish the clinic.

Clinical Center director Dr. John Gallin pledged, "As the clinic project evolves, and needs become clear, ask us to help. We are fully committed to this project."

The clinic will expose additional doctors to the subspecialty of pediatric rheumatology, an area of medicine that is greatly underserved. According to a 1999 report from the American Board of Medical Specialties, there are only 162 pediatric rheuma-tologists in the United States, and most are clustered around large cities. There are no pediatric rheumatologists at all, for example, in Idaho, Maine or North Dakota.

Staffing the clinic are a host of medical professionals from NIH and the private sector, including pediatric rheumatologists, pediatricians, nurse practitioners, research nurses and fellows.

Dr. Barbara Mittleman, a rheumatologist, directs NIAMS scientific interchange.

"Rheumatic diseases in children can compromise many developmental and educational tasks," said Dr. Barbara Mittleman, a rheumatologist and NIAMS director of scientific interchange. "Early and effective treatment can restore or improve the chances of kids with rheumatic diseases to enjoy childhood."

"This is a dream come true," said Dr. Robert Lipnick, a pediatric rheumatologist in private practice in Bethesda, who helps staff the clinic along with NIAID's Dr. Karyl Barron, a pediatric rheumatologist and NIAMS's Dr. Raphaela Goldbach-Mansky, a pediatrician. "I am extremely excited about this clinic," Lipnick said. "It will provide a tremendous opportunity for training young physicians to diagnose and treat children with rheumatic diseases and for conducting innovative and unique research studies. It also offers children all over the country the chance to participate."

Pediatric rheumatic diseases include juvenile rheumatoid arthritis, lupus, scleroderma, dermatomyositis, familial fever syndromes and other chronic diseases that affect the joints, muscles, bones and skin.


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