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Department of Paediatrics
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Rheumatology


Dr. Brian Feldman - Division Head

The Division of Rheumatology has general rheumatology clinics, as well as subspecialty clinics for children with systemic lupus erythematosus (SLE), juvenile dermatomyositis, spondyloarthropathies, scleroderma and systemic onset juvenile rheumatoid arthritis.

The Rheumatology undergraduate educational activities include lectures, seminars, electives, ambulatory and community experience. Postgraduate educational activities include the regular PGY2 rotations, lectures and seminars (also includes research electives). The division supports continuing education activities through annual updates and community-based seminars. The division is a Royal College of Physicians and Surgeons of Canada accredited fellowship program in Paediatric Rheumatology.

Clinical research foci include: JRA, SLE, neonatal lupus erythematosus, dermatomyositis and scleroderma. The division also carries out fundamental laboratory based research that is relevant to Kawasaki disease, neonatal lupus and chronic recurrent multifocal osteomyelitis.

History

In 1983, the University of Toronto made a commitment to recruit several paediatric rheumatologists to develop an academic program that would include clinical care, education, and research in the inflammatory disorders of bones and joints in childhood. This recruitment took place within the division of immunology, and it was only in 1990 that rheumatology was established as a separate division within the Department of Paediatrics.

The current professional staff includes five full-time and two part-time paediatric rheumatologists, two nurses, a physiotherapist, an occupational therapist, and a social worker, making the Division the largest of its kind in Canada and one of the largest in North America.

The number of patient visits has more than doubled over the past ten years, and the division now sees eight to ten new patients per week. This dramatic increase in patient load is reflected in the clinical program, which originally consisted of three weekly clinics in general rheumatology and now includes specialized clinics for children with lupus, dermatomyositis, systemic juvenile rheumatic arthritis, scleroderma, and spondylitis.

The division has played a prominent role in the paediatric rheumatology research world, with over 100 publications originating from its members. One of the most exciting research achievements this year has been the development of an animal model of congenital heart block, which is expected to be of great value in studying neonatal lupus erythematosus. In addition, promising new treatments are being developed for children with juvenile rheumatoid arthritis.



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