CHOC Becomes SCID Referral Center

CHOC Children’s is pleased to have recently become a referral center for severe combined immune deficiency (SCID), filling a regional gap that once required Orange County infants to go outside the county for care.

Led by Drs. David Buchbinder, Wan-yin Chan, Diane Nugent and Jasjit Singh, the immunodeficiency program is a multidisciplinary effort crossing multiple specialties at CHOC including allergy and immunology, hematology and infectious disease

Though they appear healthy at birth, infants with this primary immunodeficiency disease lack T lymphocytes, one of the white blood cells that help fight infections. 

Babies with SCID cannot fight even the most innocuous infections and often die. The condition is considered by the medical community as a pediatric emergency.

“Prior to development of SCID newborn screening, the diagnosis would be delayed,” Dr. Chan says. “Often times these patients would not get sick until after 6 months of age. No one would know they were affected until the antibodies from their mother would wane. They end up with life threatening infections with serious complications often resulting in death.”

However, studies show that early bone marrow or stem cell transplants can improve outcomes significantly, Dr. Chan says.

Survival rates increase to 94 percent if administered to an affected infant by age 3 ½ months. However, if transplants occur after that age, survival rates increase to only 70 percent, underscoring the importance of early detection and intervention. 

To that end, California became one of the first states to add SCID to its list of recommended newborn screenings in 2010. In the years since, all states have followed suit. 

Under CHOC’s program, immunodeficiency team physicians review each case of Orange County babies who test positive in newborn screenings for SCID and ask parents to immediately seek a confirmatory blood test for the infant, Dr. Chan says.

If the additional tests confirm the diagnosis, patients are urgently admitted to CHOC for workup and treatment, Dr. Chan says.

Since CHOC’s center was formed in August, more than 20 patients have been flagged in the surrounding communities and each individual case has been reviewed by the immunodeficiency team in collaboration with local pediatricians.

Those urgent blood tests confirmed the presence of SCID or a SCID-like disorder in more than 25 percent of cases thus far. 

Study shows obese, asthmatic patients benefit from CHOC Breathmobile

Obese children who regularly participate in CHOC Children’s mobile asthma program could realize good control of their asthma, a retrospective study of more than 1,200 patients reveals.

Study findings showed no difference in the time it took for morbidly obese children and children with normal weights to reach asthma control – so long as they didn’t exceed 90 days between Breathmobile visits.

Dr. Stanley Galant, CHOC allergist/immunologist and Breathmobile medical director, presented these findings at the American Academy of Allergy, Asthma & Immunology (AAAAI) recent annual meeting. This work, “Can asthma be well controlled with NAEPP guideline care in morbidly obese children? The Breathmobile,” was also published in the Annals of Allergy, Asthma & Immunology.

The study examined 1,204 children ages 3 to 18 who were diagnosed by a physician with asthma between 2003 and 2012. Of the patients, more than half were considered overweight, obese or morbidly obese.

Dr. Stanley Galant, CHOC allergist/immunologist and Breathmobile medical director

About 80 percent of Breathmobile patients achieved well-controlled asthma by their third visit. Additionally, participants across all body mass index (BMI) categories saw at least a 60 percent reduction in the likelihood of emergency department visits, hospitalizations, school absences and exercise limitations, even without a change in their BMIs.

CHOC’s Breathmobile is the only mobile asthma clinic dedicated to serving preschool and school-aged children in Orange County. An important community service, it removes barriers for children and their families who may be unable to travel or pay for preventive asthma care.

The Breathmobile’s two 36-foot RV-style clinics travel to 22 schools and community sites providing asthma care, diagnosis and education. Each location is visited every four to six weeks, providing children with comprehensive follow-up care from a familiar team until their asthma is controlled.

In his presentation, Dr. Galant attributed the Breathmobile’s success to cultural compatibility; patient access to community-based specialty care; adequate education for self-management; and most important, continuity of care, particularly for patients considered morbidly obese.

 

CHOC allergist recognized for service to children with asthma

A CHOC Children’s allergist has been honored for his longtime work to help children with asthma in the community.

Recognizing his achievements in air quality and medicine, Dr. Stanley Galant, medical director of CHOC’s Breathmobile, received the Robert M. Zweig, M.D., Memorial Award from the South Coast Air Quality Management District (SCAQMD).

The accolade is part of the agency’s 29th annual Clean Air Awards, which recognize people, businesses and public agencies that make significant contributions to cleaner air in Southern California.

CHOC’s Breathmobile is the only mobile asthma clinic dedicated to serving preschool and school-aged children in Orange County. An important community service, it removes barriers for children and their families who may be unable to travel or pay for preventive asthma care.

The Breathmobile’s two 36-foot RV-style clinics travel to 22 schools and community sites providing asthma care, diagnosis andeducation. Each location is visited every four to six weeks, providing children with comprehensive follow-up care from a familiar team until their asthma is controlled.

SCAQMD is the air pollution control agency for Orange County and portions of Los Angeles, Riverside and San Bernardino counties.