| General Paediatrics | Cardiology | Endocrinology & Metabolism | Haematology & Oncology |
| Immunology, Rheumatology & Infection | Neurology, Developmental Paediatrics & Neurohabilition |
| Paediatric Intensive Care & Neonatology |
Chinese

Clinical Sub-specialties
Immunology, Rheumatology and Infectious Diseases
(
免疫學、風濕病學及傳染病科 )

Immunology, Rheumatology and Infectious Diseases Team Heads
Prof Yu-lung Lau
Chair Professor & Head
劉宇隆教授
Prof Allan Sik-yin Lau
Professor
劉錫賢醫生
Dr Susan Chiu
Associate Professor
招瑞生醫生
Dr Tsz-leung Lee
Associate Consultant
李子良醫生
Dr Marco Hok-kung Ho
Associate Consultant
何學工醫生
Fellow:  

Activity & Service


Team PhotoImmunology/ Rheumatology

We are the referral centre for children with suspected primary immunodeficiency disorders. The disease types include antibody deficiency syndromes, severe combined immunodeficiency, common variable immunodeficiency, T-cell defects, phagocyte defects, complement disorders, lymphoproliferative disease, post-transplantation immunological diseases, organ-specific autoimmunity, hyper-IgM syndrome, hyper-IgE syndrome, etc. We provide a comprehensive diagnostic evaluation, prophylactic measures and therapeutic intervention for this group of patients. We are capable of delivering various immunological-based therapies such as immunoglobulin replacement, interferon treatment, monoclonal antibody treatment and haemopoietic stem cell transplant for selected patients. We provide genetic diagnosis and counselling on X-linked agammaglobulinaemia (XLA), Wiskott-Aldrich syndrome (WAS), X-lined lymphoproliferative disease (XLP), chronic granulomatous disease (CGD), X-linked hyper-IgM syndrome, autoimmune lympho-proliferative syndrome (ALPS) and leukocyte adhesion defect (LAD).

In addition, we deal with the diagnosis, treatment, and follow-up of children with rheumatic diseases, including juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE), reactive arthritis, juvenile dermatomyositis and other related connective tissue diseases. We also see children with limb pain and other regional musculoskeletal problems. In collaboration with radiologist, we could perform intra-articular steroid injection for young child under ultrasound guidance.

We also provide diagnostic evaluation, education and treatment of all allergic disorders of infancy, childhood and adolescent, including allergic problems involving the eyes, nose and throat; allergic skin disorders, food allergy; severe allergic reactions such as angioedema and anaphylaxis; allergies involving stinging insects, drugs, and latex. Diagnostic facilities include allergen skin testing, oral challenges with foods or drugs, and all appropriate blood tests. We also provide drug desensitization and allergen immunotherapy for selected patients.

Team photoWe run weekly immunology clinic, fortnightly allergy clinic, weekly rheumatology clinic; and bimonthly combined multi-disciplinary juvenile idiopathic arthritis clinic in conjunction with orthopaedic surgeon, physiotherapist and occupational therapist. 50-60 new case referrals were seen annually. We are currently treating 130 patients with various primary immunodeficiency disorders, over 100 patients with juvenile idiopathic arthritis, 60 patients with systemic lupus erythematosus, 40 other connective tissue-related diseases such as dermatomyositis, morphea/ scleroderma, Sjogren syndrome, Behcets disease, polyarteritis nodosa, uveitis, CINCA syndrome and many patients with allergic diseases. In collaboration with haematology and oncology team, we have performed stem-cell transplant in 20 patients with primary immunodeficiency disorder and achieved 80% disease free survival. We are also the pioneer in performing autologous transplant for refractory SLE and JIA patients among centres in Hong Kong and South East Asia.

We organize symposium and education activities for patients, allied professional and general practitioners. We are actively preparing education materials (booklet, VCD) about JIA, SLE and medications used in rheumatology for children with rheumatic diseases. An Immunology/ Rheumatology hotline is available for patients to enquire problems, medication and new symptoms between follow-up.

Infectious Disease

We manage paediatrics HIV, paediatric viral respiratory tract infections (500-600 admissions/year), and paediatric gastroenteritis (400 admissions/year). We offer consultative services to other paediatric subspecialties like intensive care, cardiology and oncology. We have liaised with day-care centres and kindergartens throughout Hong Kong to conduct community-based surveillance studies.

Our laboratory support in QMH provides rapid diagnosis of respiratory viruses (influenza A & B, parainfluenza, respiratory syncytial virus, adenovirus) in the nasopharyngeal aspirate specimen by immunofluorescence test; HIV viral load by PCR; cytokine profiles in HIV infected patients with correlation to therapy and T-cell count. The microbiology laboratory in QMH is internationally recognized for its contribution in antibiotic resistance, and is designated by WHO as a key WHONET lab for Southeast Asia and China.

There are 6 negative pressure isolation rooms for airborne precaution located in K7N ward. In the post- SARS era, K7N has been upgraded with many new facilities to aid in better infection control and prevention of nosocomial infection.

Strength & Development
We have a strong basic laboratory research component. We conduct cutting edge researches in biology related to infectious disease, SLE, immunodeficiency syndrome and developmental immunology.

We have set up a vaccine research clinic and we are actively conducting clinical trials (chickenpox vaccine, cold-attenuated live intra-nasal influenza vaccine, and rotavirus vaccine) in collaboration with major pharmaceutical enterprises.

Our team also prepares series of up-to-date management protocols to improve our patient care. These include infection control guidelines, transplant protocol for immunodeficiency and autoimmune diseases, chemotherapy protocol for SLE, and guidelines on the use of Epipen in treating anaphylaxis etc.

In view of the unmet need in Hong Kong, we are pushing forward to create a local Immunology/ Infectious Disease sub-specialty training programme in collaboration with other units. It aims at providing a broader training and in-depth experience at a sufficient level for trainees. They should then acquire the competency of specialists in Immunology/ Infectious diseases. This programme also strives to enhance critical thinking, self-learning, and serves as a commitment to continued medical education in the field.

Research/ Grant & Awards
The team was awarded with more than 11 millions HKD research grants in the last 3 years.

Blood taking for researchProf Yu-lung Lau
  1. Host immune responses to respiratory pathogens such as SARS-CoV, influenza virus and HMPV.
  2. Mannose binding lectin and dendritic cells
  3. Gene association studies in autoimmune and infectious diseases, such as SLE , SARS, HBV-related diseases and tuberculosis.
  4. Clinical trials on vaccines.

Dr Allan Lau

  1. Biology of interferon and cytokines-signaling pathways and gene regulation.
  2. Host response to virus infection- HIV and avian influenza viruses.
  3. Pathogenetic role of tumor viruses in cancer development.

Dr Susan Chiu

  1. Influenza disease burden.
  2. Emerging infection like SARS and metapneumovirus.
  3. Primary infection and reactivation of HHV6 & HHV7.
  4. S. pneumoniae carriage in children in day care and kindergarten.

Collaboration
Our team has a strong collaboration with laboratory microbiologist, clinical microbiologist and infection control experts in dealing with complex infectious diseases, especially during disease outbreaks. We work hand in hand with the Haematology/ Oncology team in performing blood or marrow transplants.

The goals of treatment of childhood immunodeficiency syndrome and rheumatologic diseases are to control disease activity, preserve normal physical, social and emotional growth and development, and to minimize chronic disability. A multi-disciplinary team approach, involving paediatricians, registered nurses, physical therapists, occupational therapists and social workers, helps to carry out these goals. We have close partnership with other professionals like nutrition experts, paediatric surgeons, paediatric orthopedic surgeons, paediatric nephrologists, paediatric ophthalmologist, paediatric cardiologists, child psychologists, child psychiatrists, maxillo-facial surgeons and paediatric dermatologists. For treating allergy diseases, we work closely with dermatologist, ENT surgeons and respirologists.

We are an active member of local collaborative study group for infectious diseases and rheumatology, guideline committees in vaccine issues. To name a few, Prof Lau serves as Chairman in Scientific Committee on AIDS and STI of the Centre for Health Protection. Dr Susan Chiu has been serving as a council member of Hong Kong Society of Infectious diseases. Dr TL Lee has been leading several local diseases surveillance programmes including JIA and primary immunodeficiency. He is also the convener of the Childhood Rheumatic Disease Advocacy Group under the Hong Kong Arthritis and Rheumatic Foundation.

To empower patients themselves, a patient support group named Childhood Rheumatic Disease Parents Support Group (?O?C-!P) was just established in Jan 2004; and members have been actively promoting their group. This is the joint effort of patients, parents and paediatric rheumatologists from 7 major HA hospitals.

Team photo