171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
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January 2006
Feature Story
Pediatric Rheumatology Program Expands
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| Richard Silver, MD |
As the primary provider of care for kids in South Carolina who have arthritis and other rheumatologic diseases,
the pediatric rheumatology program at MUSC is focused on offering optimal care to the state's children.
That determination gains fierce momentum next fall when the program welcomes a new pediatric rheumatologist, Dr. Natasha Ruth.
"It's been a goal of mind for a while to recruit a dedicated pediatric rheumatologist," says Richard Silver, MD,
director of rheumatology and immunology in the Department of Medicine. Dr. Silver holds a dual appointment in medicine
and pediatrics and oversees the pediatric rheumatology program. Prior to joining MUSC in 1981, he worked in London with
Dr. Barbara Ansell, a leading expert on juvenile rheumatoid arthritis.
MUSC's pediatric rheumatology program specializes in the treatment of children with arthritis and other rheumatic diseases
that may affect joints, muscles, bones, skin, and other tissues. Along with eight physicians and one physician's assistant,
Dr. Silver cares for children with arthritis, many types of autoimmune diseases, musculoskeletal pain and osteoporosis.
"The most frequent disease we encounter is juvenile rheumatoid arthritis, or JRA," explains Dr. Silver. A form of arthritis
in children ages 15 or younger, JRA causes inflammation and stiffness of joints. Unlike adult rheumatoid arthritis, which is
chronic and lasts a lifetime, children often outgrow juvenile rheumatoid arthritis. However, the disease can affect growth
and bone development in the growing child.
"Treating juvenile rheumatoid arthritis has taken a huge step forward with the advance introduction of biological agents such
as etanercept (Enbrel)," says Dr. Silver. "Aggressive management of joint inflammation with Enbrel and other drugs has enabled
our patients who would otherwise be on the sidelines to now participate fully in activities kids like to do, such as gymnastics,
ballet, basketball, and others. It's very gratifying to see how normal a life a child with JRA can now lead and look forward to
thanks to these types of medical advances."
The pediatric rheumatology program is very involved with the community through the Carolinas chapter of the Arthritis Foundation,
with high participation in events including its upcoming Arthritis Foundation Walk.
The program is currently involved in two clinical trials examining childhood onset lupus. The National Institute of Health's
Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial, in conjunction with Duke Medical Center/Duke Clinical
Research Institute, is studying the safety and efficacy of atorvastatin, (Lipitor) in reducing atherosclerosis in pediatric lupus.
This trial is the largest cohort of pediatric Systemic Lupus Erythematosus, or SLE, patients ever studied prospectively.
"This auto-immune disease affects a number of organs and is particularly a problem in minority populations," explains Dr. Silver.
The other study, Health Education in Lupus Patients (HELP), in conjunction with MUSC's Multidisciplinary Clinical Research Center
(MCRC), will determine the efficacy of neuro-cognitive behavioral intervention in adolescent lupus patients. Dr. Silver is the
principal investigator for the MCRC, a five-year, NIH-funded center that is studying the impact of rheumatic diseases in the minority population.
"MUSC is the only multidisciplinary site in the state with an interest in pediatric rheumatologic diseases," explains Dr. Silver.
"With the addition of our new pediatric rheumatologist, we further strengthen and enhance our dedication to treating South Carolina's children."
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