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Vol. LVII, No. 20
October 7, 2005
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NIAID Opens Pediatric Allergy Clinic

The smallest sneezes, watery eyes and itchy hives are getting help now at NIH; children who know the misery of asthma and allergies have found friends in the new NIAID Pediatric Allergy Clinic.

 
Dr. Hirsh Komarow  
Dr. Hirsh Komarow and nurses Rebecca DaMore and Dee Dee Gaskins quietly opened the clinic, located on the 11th floor of the Clinical Center, earlier this year and are now welcoming children for evaluation and treatment on referral from their family doctors. They will move shortly to the new Clinical Research Center pediatric clinic.

The staff takes care to make children comfortable during visits. "We all are pediatric specialists," says DaMore. "We are very kid-friendly."

A primary purpose of the clinic is to provide trainees in NIAID's allergy and immunology fellowship program with on-campus experience in treating children with allergic diseases including asthma. The clinic also includes a research component. The clinic enhances the training fellowship by fostering experience in pediatrics, says Komarow. The allergy and immunology fellowship is unique in that the program offers 1 year of clinical training and 2 years of research training, he adds.

"This pediatric allergy clinic strengthens the allergic diseases research and training program within the intramural program of NIAID and offers a valuable expertise for the Clinical Research Center as a premier research institution," says Dr. Dean Metcalfe, chief of NIAID's Laboratory of Allergic Diseases and director of the Allergy and Immunology Training Program.

Three to four new allergy and immunology clinical fellows join the program each year. Already trained as physicians in internal medicine or pediatrics, they evaluate and treat patients with allergic diseases, under Komarow's supervision. Fellows are required to complete rotations in the Pediatric Allergy Clinic, as well as at Walter Reed Army Medical Center, Children's National Medical Center and the inpatient ward of the CRC. One additional month consists of a combined rotation through dermatology, the CC core laboratory, ENT (ear, nose, throat) and through the pulmonary function-testing laboratory.

For their part, patients receive diagnostic testing, treatment and counseling for allergic diseases. The clinic can accommodate up to 600 patient visits per year, says Komarow.

The clinic is geared to treat typical pediatric allergy patients on an outpatient basis. NIAID fellows will treat children with asthma, nasal allergies, eczema, bee sting allergies and anaphylactic reactions. On initial visits, clinicians conduct evaluations and diagnostic tests, which include pulmonary function and allergen skin testing. Other tests include using sound waves to measure a child's nasal volume and screening bloods tests of the immune system. Interactive computer software helps assess how allergies affect children's mood and cognitive skills.

 
Nurse Practitioner Rebecca DaMore gives a pulmonary function test to patient Marin Kuntze, age 6.  

"We're looking for typical allergy patients from 6 months to 18 years old," says Gaskins. "We try to make everything as painless as possible."

Children who are recommended for allergy shots will return weekly to receive them. Otherwise, children will return for follow-up visits every 3 to 6 months as needed. Komarow says the clinic would like to follow each child for at least 1 year. Children with the most severe symptoms could potentially be seen on a long-term basis.

Komarow says the clinic will collect results from diagnostic tests in a database for pediatric allergy research. Over time, the clinic's database could reveal noteworthy trends and correlations in allergy symptoms, he says.

Using age-appropriate written questionnaires, he plans to study how allergies affect cognitive function and mood. In addition, he wants to evaluate the effects of allergies on the central nervous system. A computerized interactive diagnostic tool will record children's reaction times and responses to visual images to measure cognitive function and changes that may be correlated with worsening or improving allergic symptoms.

Parents who would like information on evaluation and treatment at the clinic may phone 1-800-411-1222; for the hearing-impaired, call 1-866-411-1010.

More information on the NIAID Allergy and Immunology fellowship program is available online at http://www.niaid.nih.gov/dir/training/allergy.htm.

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