Childhood Interstitial, Diffuse and Immunological Disorders that affect the Lung (ChILD Immune) Clinic
The Childhood Interstitial, Diffuse and Immunological Disorders that affect the Lung (ChILD Immune) Clinic at Johns Hopkins Children’s Center is a multidisciplinary clinic that sees children and adolescents with known or suspected interstitial and diffuse lung diseases, as well as immune-mediated lung disease related to autoimmune conditions, immunodeficiency, or disorders of immune dysregulation.
The innovative clinic combines teams specialized in pediatric pulmonary medicine and allergy, immunology and rheumatology in one place, making it easy for patients to see these specialists often on the same day.
Who and What We Treat
Before coming to the ChILD Immune Clinic, many of our patients have had difficulty finding an explanation for their condition or a lack of effective treatments. Our clinic is happy to offer second or third opinions on conditions evaluated at other clinics, or we can provide multidisciplinary care that is not available at other clinics.
Our clinic specializes in childhood interstitial lung disease, a group of rare pediatric lung conditions that encompasses more than 30 disorders, some of which have a known genetic cause, and most of which are very rare. These include:
- Neuroendocrine cell hyperplasia of infancy (NEHI)
- Disorders of surfactant metabolism (such as ABCA3 or surfactant protein C deficiency)
- Bronchiolitis obliterans
- Pulmonary fibrosis
- Various other disorders affecting different parts of the lungs
We also treat children and adolescents with known or suspected immune disorders that could impact the lungs. These include groups of diseases that affect the immune system including autoimmune conditions, immunodeficiency, or disorders of immune dysregulation, which encompass more than 500 known disorders, most of which are very rare. These include:
- Inborn errors of immunity, including known or suspected conditions involving the immune system, such as:
- Autoinflammatory disorders
- Immunodeficiencies
- Immune dysregulation disorders
The clinic also evaluates and treats and patients whose condition has not yet been identified. These my include:
- Rare, severe, or unexplained lung conditions.
- Bronchiectasis for which a cause has not been identified
- Asthma and airway disease that is difficult to control and or has unusual features
- Pulmonary nodules or granulomas
- Recurrent infections
- Recurrent fevers
- Unexplained hyperinflammation
- Other clinical scenarios in which an immune disorder is suspected
In addition to examining patients with unknown or possible immunological illnesses, we also see patients with known immune conditions who have additional complicating factors or symptoms that have not been alleviated by traditional treatments.
What to Expect in a Clinic Visit
Our approach to performing a workup for potential disorders may include extensive evaluation.
At the first visit, patients spend about two hours in the clinic. A thorough medical history is gathered, and testing may take place. Testing may include pulmonary function tests, bloodwork to evaluate the immune system, and genetic testing.
Additional testing may be needed after the first visit, including:
- radiology tests
- sleep studies
- swallowing evaluations
- flexible bronchoscopies
The type of testing that is ordered is tailored to the child and depends on factors such as age, pattern of symptoms, and results of preliminary tests.
Clinical Directors
Maria Jimena Gutierrez, M.D.
Sara Christina Sadreameli, M.D., M.H.S.
ChILD/Immune Clinic - Q&A
Pediatric immunologist Maria Jimena Gutierrez and pediatric pulmonologist Christy Sadreameli discuss the multidisciplinary approach to care and research offered at the ChILD/Immune Clinic at Johns Hopkins Children's Center.
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Our Research
Our team participates in research that directly influences the diagnosis and treatment of ChILD disorders and immune-mediated lung diseases. These developments are important to the continued progress of how these conditions are treated around the world.
Our clinic is a participating site in the ChILD Foundation registry, which is a network of clinics and centers dedicated to the research and pursuit of better understanding and development of effective treatments and cures for diseases under the umbrella of chILD.
We also have our own registry and collect data from our patients to study how interstitial/diffuse and immune diseases affecting the lungs occur and affect our patients.
Publications:
Gutierrez MJ, Nino G, Sun D, Restrepo-Gualteros S, Sadreameli SC, Fiorino EK, Wu E, Vece T, Hagood JS, Maglione PJ, Kurland G, Koumbourlis A, Sullivan KE. The lung in inborn errors of immunity: From clinical disease patterns to molecular pathogenesis. J Allergy Clin Immunol. 2022 Dec;150(6):1314-1324. doi: 10.1016/j.jaci.2022.08.024. Epub 2022 Oct 14. PMID: 36244852; PMCID: PMC9826631.
Nevel RJ, Deutsch GH, Craven D, Deterding R, Fishman MP, Wambach JA, Casey A, Krone K, Liptzin DR, O'Connor MG, Kurland G, Taylor JB, Gower WA, Hagood JS, Conrad C, Tam-Williams JB, Fiorino EK, Goldfarb S, Sadreameli SC, Nogee LM, Montgomery G, Hamvas A, Laguna TA, Bansal M, Lew C, Santiago M, Popova A, De A, Chan M, Powers MR, Josephson MB, Camburn D, Voss L, Li Y, Young LR; chILD Registry Collaborative. The US national registry for childhood interstitial and diffuse lung disease: Report of study design and initial enrollment cohort. Pediatr Pulmonol. 2023 Jul 4:10.1002/ppul.26568. doi: 10.1002/ppul.26568. Epub ahead of print. PMID: 37401889; PMCID: PMC10764638.
Correa-Jimenez O, Restrepo-Gualteros S, Nino G, Cunningham-Rundles C, Sullivan KE, Fuleihan RL, Gutierrez MJ. Respiratory Comorbidities Associated with Bronchiectasis in Patients with Common Variable Immunodeficiency in the USIDNET Registry. J Clin Immunol. 2023 Nov;43(8):2208-2220. doi: 10.1007/s10875-023-01593-6. Epub 2023 Nov 7. PMID: 37932514.