Rheumatology

Dr. David Cabral, Division Head

The BC Children’s Hospital (BCCH) Division of Rheumatology provides diagnosis and treatment with a comprehensive and coordinated multidisciplinary team for children and adolescents with rheumatic diseases. These diseases include chronic arthritis (juvenile idiopathic arthritis), systemic lupus erythematosus, dermatomyositis, scleroderma, vasculitis, auto-inflammatory disease, musculoskeletal pain syndromes and other less common inflammatory diseases.

Our vision is to maintain an excellent, province-wide, diagnostic service, providing timely access for children with potential life threatening or disabling inflammatory / autoimmune rheumatic disease, and to provide them with the best possible ongoing inter-professional team care. Our ongoing mandate is to maintain quality and improve our level of patient care & patient outcomes; as such ‘best’ care is assured by providing  clinical care in an academic environment with integrated research, teaching and patient engagement with particular consideration for equity and diversity.

UPDATED July 3 2020

 
 

The Division of Rheumatology has a strong research program, which includes both clinical and basic research in inflammatory rheumatic diseases of childhood.  Our faculty are active members of the BC Children’s Hospital Research Institute; in addition we have active collaborations with Canadian (Canadian Rheumatology Association- Pediatric Section; Canadian Alliance for Pediatric Rheumatology Investigators - CAPRI); North American (Children’s Arthritis and Rheumatic diseases Research Association - CARRA; Pediatric Rheumatology Collaborative Study Group  PRCSG), and international (- Understanding Childhood Arthritis Network: Canada/Dutch - UCAN-CAN DU; Pediatric Rheumatology International Trials Organization - PRINTO; Pediatric Rheumatology European Society - PRES) pediatric rheumatology research groups.

Members of the Division are leaders in the development of Canadian and North American pediatric multi-centre clinical research cohorts in juvenile arthritis, vasculitis, and auto-inflammatory diseases.

Our pediatric rheumatology laboratory is led by Dr. Kelly Brown, at the BCCH Research Institute, whose lab is focused on childhood vasculitis, understanding the inflammatory mechanisms of childhood rheumatic disease, and auto-inflammatory diseases.   See the lab website for further information:   http://www.kbrownlab.ca

Our research is integrated into routine clinical care, to ensure the best care and quality improvement.  Our vision is that every child and family has the opportunity to participate in rheumatology research, making research participation easy, relevant, and family-centered. Our staff members mentor trainees in research projects, including pediatric rheumatology subspecialty trainees, pediatric residents, medical students and undergraduate students.

Current research interests include:

  • Juvenile idiopathic arthritis

- Biomarkers and genomics of methotrexate intolerance in children with JIA
- Preventing methotrexate side effects in JIA: a randomized controlled trial
- Predicting course of disease in children with JIA
- Exercise and physical activity in children with JIA and rheumatic disease

  • PedVAS: an international registry and research program in childhood vasculitis
  • PARC: Pediatric Auto-inflammatory disease Research Consortium

- CAN-Fever- longitudinal patient registry
- Translational research in auto-inflammation

  • Impact of childhood rheumatic disease on work in youth and young adults
  • Uveitis in children: translational research and family online self-management

Teaching is an important part of the pediatric rheumatology team’s mission. The pediatric rheumatologists, together with their team members, teach medical students, residents, and other health professionals from Canada and around the world. The Division has one of only three Royal College approved training programs for pediatric rheumatology in Canada. Our innovative rheumatology academic half-day curriculum, developed by our own division members, has been very successful and subsequently shared with other training programs at their request. Over the past 15 years, the Subspecialty Training Program has trained over 25 pediatric rheumatologists from North America, Europe, the Middle East, Australia, Jamaica and Asia.

For more information regarding our pediatric rheumatology fellowship training program please visit: https://www.carms.ca/match/psm/program-descriptions/

The Division participates in Department of Pediatrics teaching activities, such as academic half-day for residents, Advances in Pediatrics, and Pediatric Grand Rounds. Within the division, we participate in weekly multidisciplinary patient follow up meeting and radiology rounds.  The members of the Division all have an active schedule of external teaching lectures in Canada and beyond.

The Pediatric Rheumatology Team

Clinical care for children and youth with rheumatic diseases is provided by a multidisciplinary care and research team, which includes pediatric rheumatologists, trainees, research associates, nurses, pediatric rheumatology physiotherapists and occupational therapists, and a social worker. In addition to the pediatric rheumatology team, care may also be provided in close collaboration with other pediatric subspecialists such as pediatric orthopedic surgeons, pediatric dermatologists, pediatric ophthalmologists, pediatric radiologists and other pediatric specialists. This coordinated team approach is a holistic model of health care deliver that best addresses the broad impact of these chronic diseases.

Programs and Services in BCCH

The Pediatric Rheumatology program provides coordinated care for children and youth with rheumatic disease through the following services:

  1. Diagnostic consultation service.
  2. Rheumatology follow-up clinics for patients diagnosed with definite rheumatic diseases; juvenile idiopathic arthritis, systemic lupus erythematosus, dermatomyositis, vasculitis, scleroderma, auto-inflammatory disease and other rare autoimmune or inflammatory disorders.
  3. Consultation and treatment by specialized pediatric rheumatology physiotherapists and occupational therapists.
  4. Individual combined specialty clinics with subspecialists from nephrology, neurology and dermatology to provide coordinated care for patients with complex conditions.
  5. A transition program for youth focuses on providing support to youth to become independent in the management of their health care as they move to adult rheumatology services. The first phase of this program in BCCH is integrated with routine follow-up clinics. The second phase after BCCH discharge comprises a specialised clinic for youth aged 18-22 years, called The Young Adults with Rheumatic Diseases (YARD) clinic.. This clinic is held at the Mary Pack Arthritis Centre, with the help of adult rheumatologists.
  6. Weekly Procedures clinic for joint injections, done under conscious sedation.
  7. Supervision of medication infusions for our patients in the Medical Day Unit at BC Children’s Hospital.
  8. Telephone consultations to pediatricians and family doctors across the province.

Outreach

The Pediatric Rheumatology Program is a province-wide resource for patients, families and physicians. Pediatric rheumatology traveling Outreach clinics regularly occur in Surrey, Prince George, Terrace and Penticton and now account for nearly 15% of patient encounters for our provincial program. The outreach team includes physicians, nurses, occupational and physical therapists and trainees.  In addition, Dr. Roxanna Bolaria, a ‘graduate’ of our pediatric rheumatology training program has an established pediatric rheumatology program with services in Victoria.

Pediatric Rheumatologists:
David Cabral, MBBS, FRCPC, Division Head
Jaime Guzman, MD, MSc, FRCPC
Kimberly Morishita, MD, MSc, FRCPC
Lori Tucker, MD, FRCPC, FAAP
Kristin Houghton, MD, FRCPC, Dip Sports Med
Mercedes Chan, MBBS, MHPE, FRCPC, Program Director
Andrea Human, MD, FRCPC
Ross Petty, MD, PhD, FRCPC, Emeritus

Pediatric Rheumatology Nurses:
Jenny Tekano
Jayne Green
Glenda Avery
Laura Musyj

Pediatric Rheumatology Fellows:
Hon Yan Ng
Tara McGrath
Meghan McPherson
Tristan Kerr
Jonathan Park
Stephanie Wong

Pediatric Physiotherapists and Occupational Therapists:
Iris Davidson
Jennifer Brown

Pediatric Social Worker:
Meghan Kennedy

Research Staff:
Angelyne Rivera - Research Manager
Kevin Chang - Research Assistant

Pediatric Rheumatology Research Laboratory:
Kelly Brown, PhD, Principal Investigator
Stephanie Hughes, Laboratory Manager
Martina Sundqvist, PhD, Visiting Scientist
Kristen Gibson, PhD Candidate, UBC Medical Genetics
Iwona Niemietz, PhD Candidate, UBC Microbiology & Immunology
Liliana Jimenez, MSc Candidate, UBC Microbiology & Immunology
Sarah Bowers, Undergraduate Researcher, UBC Biochemistry
Rafid Haq, Undergraduate Researcher, UBC Microbiology & Immunology

Administration:
Brandy Currie
Jessie Shen

Contact Information:
4480 Oak Street
Room K4-120
Vancouver, BC, V6H 3V4

Phone: 604-875-2437 or 604-875-3678
Fax: 604-875-3141

More information:
http://www.bcchildrens.ca/our-services/clinics/rheumatology#About