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Rady Children's Specialists

Allergy & Immunology

Severe Asthma Clinic

At the Severe Asthma Clinicmultidisc-severe-asthma-clinic, children with severe and persistent uncontrolled asthma are evaluated by the clinical team and tested for appropriate allergens and other factors that may be causing their condition. They also undergo pulmonary function testing, are evaluated for social factors that may be contributing to their disease, are educated on their disease and potential therapeutic interventions, and are provided with an integrated care plan.

Our clinical team consists of pediatric allergists/immunologists (Sydney Leibel, M.D., and Bob Geng, M.D.), a pediatric pulmonologist (Mateja Cernelc-Kohan, M.D.), a pharmacist,  a social worker, a respiratory therapist and a registered nurse. There are several clinical studies currently underway that are available and will be offered to patients who are interested and meet appropriate criteria.

About Severe Asthma

Children with severe asthma require frequent or high doses of oral or systemic steroids to control their asthma. Many of these children still have symptoms even while on high steroid doses. Children with severe asthma tend to fall into two categories: difficult-to-treat asthma or severe therapy-resistant asthma.

Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities and poor adherence due to adverse psychological or environmental factors. Low-income patients have higher asthma severity, poorer asthma control and higher rates of asthma emergency department visits and hospitalizations.  Evaluating the patient from a 360-degree view, which involves factoring in other medical conditions, addressing home exposures (mold, dust), assessing access to medication and health services, looking at tobacco exposure, and dealing with school issues, are all important and can all contribute to the clinical picture.

Incorporating a multidisciplinary model that addresses the medical and social needs of children with asthma has shown demonstrable improvement in quality of life and symptom-free days, as well as decreased hospitalizations and ER visits in children with severe uncontrolled asthma.

Typical treatment options include allergen avoidance, inhaled steroids and newer biologic therapies, including Xolair(Anti-IgE) and Mepolizomab (Anti- IL-5). Other treatments are currently under investigation.


Community Approach to Severe Asthma (CASA)

The Community Approach to Severe Asthma (CASA) is an innovative program that incorporates community health workers (CHWs) into our Severe Asthma Clinic.

High-risk patients and their families are recruited to the program through the Hospital and subspecialty clinics. The CHWs work with these families to better manage their child’s asthma by performing an in-home assessment of potential asthma triggers and providing free products and resources to help reduce these triggers.

The CHWs participate in the clinic visit and follow up with patients afterwards, helping families to better understand their child’s medications and care plan, as well as working to reduce barriers to available treatment. Our CHWs are extensively trained and interact with the family and medical team to provide the best possible care.

Contact Us

For more information, call Maureen Ghiroli at 858-966-1700, ext. 224214.