Melissa Lerman

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Assistant Professor of Clinical Pediatrics
Instructor in Pediatrics, Perelman School of Medicine at the University of Pennsylvania
Department: Pediatrics

Contact information
Division of Rheumatology
The Children's Hospital of Philadelphia
Abramson Research Center, Suite 1107C
3615 Civic Center Boulevard
Philadelphia, PA 19104
Office: 215-590-7180
Fax: 215-590-4750
BA (Biology)
Yale University, 1996.
PhD (Immunology)
University of Pennsylvania School of Medicine, 2003.
MD (Medicine)
University of Pennsylvania School of Medicine, 2005.
MSCE (Masters of Science and Clinical Epidemiology, Pharmacoepidemiology)
Perelman School of Medicine at the University of Pennsylvania, 2012.
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Description of Research Expertise

I care for children with a wide range of autoimmune and auto-inflammatory diseases. These diseases include, but are not limited to, Juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE), juvenile dermatomyositis (JDMS), idiopathic uveitis, vasculitides (such as Kawasaki disease, Henoch Schönlein Purpura, Polyarteritis nodosa, Granulomatosis with polyangiitis, and Takayasu arteritis), periodic fever syndromes, and Chronic recurrent non-infectious multifocal osteomyelitis (CRMO). My research focuses on understanding juvenile idiopathic arthritis (JIA), in particular its manifestations of uveitis and temporomandibular joint (TMJ) arthritis.

Uveitis, inflammation of the eye, commonly occurs in rheumatologic diseases and may affect up to 20% of children with JIA. Uveitis can be vision threatening, and, historically, resulted in blindness. Children with uveitis are treated with a combination of topical corticosteroids and other immunomodulatory therapies. Yet there is limited research describing the impact of these medications on the natural history of uveitis. I study the outcomes of children treated with anti-TNF-alpha inhibitor treatment for uveitis. I have described how quickly uveitis is controlled under these medications1. I am currently examining how long disease remains quiet once anti-TNF-alpha therapy is discontinued. I am collaborating with pediatric rheumatologists and ophthalmologists from across the country to develop consensus treatment guidelines for uveitis (Childhood Arthritis & Rheumatology Research Alliance). Along with an ophthalmology colleague, Dr. Stefanie Davidson, I co-founded and co-direct one of the few combined rheumatology-ophthalmology uveitis clinics in the nation. In the Uveitis Coordinated Care Clinic (UCCC) we bring the most up-to-date understanding of uveitis therapies to the clinic while simultaneously providing more streamlined, high quality care to patients and their families.

Between 39 to 87% of children with JIA develop TMJ arthritis during the course of their disease. TMJ arthritis can damage the mandibular condyles and interfere with mandibular growth in children who have not reached skeletal maturity. Because of this, it can result in orofacial pain, growth abnormalities (overbite, small jaw, jaw asymmetry) and functional limitations. Together with specialists from oral and maxillofacial surgery, I am examining: the long term effects of TMJ arthritis on facial deformity and dysfunction in adults with JIA; and the affect of alternate childhood therapies on these outcomes. In future work, we hope to examine the affect of alternate treatments (intra-articular injections and systemic immunomodulatory agents) on achieving disease control and limiting long term TMJ complications.

I approach research questions by combining my clinical training in pediatric rheumatology, background in basic immunology (PhD in regulatory T cell development), and rigorous training in pharmacoepidemiology (Masters of Science in Clinical Epidemiology). In the long term, I plan to use the results from these studies to inform the development of standardized screening and treatment guidelines for children with JIA

Description of Itmat Expertise

Clinical immunology
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Last updated: 07/24/2018
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