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Hospital Nacional Edgardo Rebagliati Martins (Lima, Peru)

 

Hospital Nacional Edgardo Rebagliati Martins – EsSalud Allergy and Clinical Immunology Division     

Address: Av. Edgardo Rebagliati Nº 490 - Jesús María, Lima, Perú.
Foundation date: 3 November 1958
Medical assistance level: Level IV hospital (national hospital)
Hospitalization capacity: 1,604 beds

Mission: To offer state-of-the-art preventive, diagnostic and therapeutic methods for management of children and adults with allergic and immunologic diseases living in Peru. To provide them physical, emotional, and spiritual care.

Faculty: Currently, seven health professionals work in the Allergy and Immunology Division:
Enrique Cachay, MD. Chief.
Armando Koo, MD.
Juan Carlos Aldave, MD.
Guisela Alva, MD.
Mariela Milla, MD.
Kiars Themme, MD.
Isabel Gutiérrez, Biologist.

        

Fellows: Currently, we have four fellows in training:
Liz Veramendi, MD.
Claudia Rentería, MD.
Carla García, MD.
Maria Siccha, MD.

Clinical and Research Units:
Drug Allergy Unit
Coordinator: Guisela Alva, MD
Food Allergy Unit
Coordinator: Mariela Milla, MD
Primary Immunodeficiency Unit
Coordinator: Juan Carlos Aldave, MD
Respiratory and Skin Allergy Unit
Coordinator: Enrique Cachay, MD
Allergen Immunotherapy Unit
Coordinator: Kiars Themme, MD
Allergy & Immunology Research Unit
Coordinator: Juan Aldave, MD
Medical Education Unit
Coordinator: Armando Koo, MD
Quality of Life and Spiritual Health Unit
Coordinator: Juan Carlos Aldave, MD

Clinical work in Allergies:

Monthly, we follow in the Allergy & Immunology outpatient clinic around 1200 patients with allergic and immunologic diseases (51% children and 49% adults):

720 patients with respiratory allergies (allergic rhinitis, bronchial asthma, chronic sinusitis, and chronic pharyngitis).
264 patients with skin diseases (urticaria, atopic dermatitis, insect allergy and contact dermatitis).
120 patients with adverse drug reactions and food allergies (both IgE and non-IgE mediated).
100 patients with primary immunodeficiencies.

We perform an average of 50 consults/month to hospitalized patients. The major diagnosis is adverse drug reactions (58% of requests). Every month we do around 15 drug provocation tests, 45 allergen skin tests, and one drug desensitization procedure.Recently, we have relaunched the “Specific Allergen Immunotherapy Program” for the treatment of IgE-mediated respiratory allergies. In addition, we manage patients with severe allergic diseases using biologic therapies such as omalizumab.

Clinical work in Primary Immunodeficiencies:

Monthly, we follow around 100 patients with suspicion of Primary Immunodeficiencies (PIDs) and give intravenous immunoglobulin to 40 of them. During the last 9 years, with God’s blessings and international collaboration, we reached the following achievements:

110 patients with genetic diagnosis of PIDs.
5 patients with phenocopies of PIDs.
7 patients with hematopoietic stem cell transplantation.
1 patient with gene therapy.

Ongoing projects:
“Immunocytes on TV: spreading immunology knowledge worldwide”, supported by the Jeffrey Modell Foundation, from year 2019.
“Finding NEMO in Peru: to detect, characterize and treat the first 10 patients”, supported by the Jeffrey Modell Foundation, from year 2019.
“Saving Peruvian patients with chronic granulomatous disease”, supported by LASID/Takeda, year 2019. www.savingcgdpatients.org

Recent publications:

Leiding JW, et al. Hematopoietic stem cell transplantation in patients with Gain of Function STAT1 Mutation. J Allergy Clin Immunol. 2018 Feb;141(2):704-717.e5. doi: 10.1016/j.jaci.2017.03.049. Epub 2017 Jun 7.

Chinn IK, et al. Genetic and mechanistic diversity in pediatric hemophagocytic lymphohistiocytosis. Blood. 2018; 132(1): 89-100.

El-Sayed ZA, et al. X-linked agammaglobulinemia (XLA): Phenotype, diagnosis, and therapeutic challenges around the world. World Allergy Organization Journal. 2019; 12(3): 1-9.

Mamcarz E, et al. Lentiviral Gene Therapy Combined with Low-Dose Busulfan in Infants with SCID-X1. N Engl J Med 2019; 380:1525-1534.

Bustamante Ogando JC, et al. Latin American consensus on the supportive management of patients with severe combined immunodeficiency. J Allergy Clin Immunol. 2019 Aug 13. pii: S0091-6749(19)31040-1. doi: 10.1016/j.jaci.2019.08.002. [Epub ahead of print].