Allergy, Immunology & Rheumatology Section

Allergy, Asthma & Immunology Program

Allergic diseases are among the most common causes of chronic disease in childhood, with asthma being the most common reason for hospitalization and lost school time in childhood. Allergic diseases include allergic rhinitis and conjunctivitis (often called "hay fever" or "allergies"), asthma (characterized by coughing and wheezing at night, with exercise and significant worsening with viral infections), food allergy, drug allergy, stinging insect allergy, eczema, urticaria ("hives") and recurrent or chronic sinusitis. The diagnosis and management of these diseases is best coordinated by a specialist in Allergy and Immunology, in concert with a child’s primary care provider.

The pediatric specialists in the Allergy, Asthma & Immunology program assist in the diagnosis and management of children with a variety of known or suspected allergic and immunological diseases. Diagnostic services include skin and blood testing for specific allergies, lung function testing for asthma, serological evaluation of immune function, and oversight of specialized testing for asthma, including methacholine and exercise challenge. Drug and stinging insect allergy are assessed with review of the history and specialized skin testing when appropriate. Therapeutic services include oversight of drug management for allergic diseases, development of asthma treatment plans for those who need them (with instruction in inhaler use), development and implementation of allergen immunotherapy (“allergy shots”), and use of immunological therapies such as intravenous immunoglobulin and anti-IgE therapy.

In March of 2012 UNC Pediatrics welcomed Dr. Wesley Burks as the Department Chairman and The Physician in Chief of NC Children’s Hospital. Dr. Burks is an internationally renowned expert in pediatric allergy and immunotherapy research. His clinical and research groups are leaders in the development of immunotherapy for food allergy and assays to monitor immune responses in children. Over the last decade Dr. Burks has worked to better understand immunologic mechanisms of food allergy so that long-term safe and therapeutic treatments can be developed.

Children with asthma are managed within the Children’s Asthma Management Program of the NC Children’s Hospital, which is a long standing collaborative effort overseen by the Allergy, Asthma & Immunology Program of the Division of Immunology & Infectious Disease and the Division of Pediatric Pulmonology, as well as the Pediatric Emergency Department, General Pediatric Service, the Pediatric Intensive Care Unit, the NC Children’s Hospital Pharmacy, Respiratory Therapy and Nursing Services. Immunological therapies for children’s asthma are coordinated by the Allergy, Asthma & Immunology program.

Members of this program are internationally known leaders in clinical research of allergic diseases and asthma in both children and adults. This research is conducted by division members at the UNC Center for Environmental Medicine, Asthma and Lung Biology, and focuses on the impact of environmental pollutants in asthma (and other lung diseases) and new drug therapies for these diseases. These studies are funded by and done in conjunction with the US EPA, the NIH and the pharmaceutical industry.

Pediatric Rheumatology and Immunology Program

Children, like adults, may become affected by a variety of rheumatologic disorders – diseases resulting from one’s immune system reacting against one or more tissues in the body. Such diseases can manifest as inflammation (redness and swelling) in joints (arthritis), muscles, blood vessels and other organs. The diagnosis and management of these diseases is best coordinated by a specialist in Pediatric Rheumatology.

The pediatric specialists in the UNC Pediatric Rheumatology and Immunology section assist in the diagnosis and management of children with a variety of known or suspected rheumatologic as well as autoimmune diseases (diseases caused by an immune response of the body against substance normally present in the body). Children are commonly referred for outpatient evaluation and management of various types of arthritis (including juvenile rheumatoid arthritis), vasculitis, systemic lupus erythematosus, scleroderma, and other rheumatologic and autoimmune disorders. Children with serious or life-threatening manifestations of these diseases are usually evaluated by the Pediatric Rheumatology specialists in an inpatient setting at NC Children’s Hospital.

Pediatric Infectious Disease Section

Pediatric Infectious Disease and FUO Program

Childhood infections are one of the most common reasons for a parent to bring a child to see a healthcare provider. While the majority of infections are benign and recovery is quick, situations do arise when consultation with a specialist is needed for evaluation of children with recurrent, prolonged, or severe infections.

The pediatric specialists in the Infectious Disease and Immunology section assist in the diagnosis and management of children with a variety of known or suspected infections as well as immune deficiencies. Children are commonly referred for outpatient evaluation of recurrent or prolonged infections, persistent fever, suspected immune deficiency, enlarged lymph nodes, pneumonia, and a wide range of childhood infections. Children with meningitis, encephalitis, bone infections, endocarditis, and a spectrum of serious or difficult-to-treat infections are usually evaluated by the Infectious Disease specialists in an inpatient setting at NC Children’s Hospital.

Pediatric and Adolescent HIV Program

HIV infection continues in epidemic proportions worldwide. However, significant advances in the reduction of perinatal transmission (passed to the baby while in the mother's womb or during labor and delivery) and treatment of HIV disease continue to alter and mold standards of HIV medical management in the United States. Physicians caring for HIV-infected children must strive for optimal medical management of the infection to assure the best quality of life possible for each child.

The pediatric and adolescent HIV specialists in the Infectious Diseases and Immunology section assist in the management of infants, children, and adolescents exposed to or infected with HIV. The location of outpatient clinic visits in the combined UNC Adult-Children’s Infectious Disease Clinic helps to facilitate coordinated medical care for all HIV-infected family members. The pediatric and adolescent HIV care team recognizes that each child has unique health care needs, which are best addressed in the context of the family and social environment. The team strives to use all available resources to optimize control of the HIV infection but also enrich the child’s nutrition and development, address emotional and spiritual issues, and enhance the child’s quality of life.

The UNC Pediatric and Adolescent HIV Program is a member of the Pediatric AIDS Clinical Trials Group and the UNC Center for AIDS Research. Our participation in these groups allows the children in our care the opportunity to participate in multiple national and international clinical trials and access to state-of-the-art HIV therapy.

Host Defense and Immunology Program

Evaluation of host defense and immune deficiency problems is coordinated through the Host Defense and Immunology Program, generally in the ID/FUO and Allergy, Asthma and Immunology Clinics. These evaluations include assessment of cellular and humoral immune response, phagocyte function and cilia morphology to assess for primary ciliary dyskinesia.