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 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."
|Dr. Hirsh Komarow
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
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,
"We're looking for typical allergy patients from 6 months to 18
years old," says Gaskins. "We try to make everything as painless
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,
More information on the NIAID Allergy and Immunology fellowship
program is available online at http://www.niaid.nih.gov/dir/training/allergy.htm.