Activity & Service

Immunology/ 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.

We 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.

Prof Yu-lung Lau

Dr Allan Lau

Dr Susan Chiu