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Laura B. Lewandowski, MD

Clinical Fellow, Systemic Autoimmunity Branch, NIAMS/NIH

About the Researcher

Dr. Laura B. Lewandowski joined the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health in 2015 under Dr. Mariana Kaplan as a Lawrence Shulman Scholar in Translational Medicine. Her current research interests include clinical and translational research in pediatric systemic lupus erythematosus (SLE). She continues fostering her passion for both pediatric rheumatology and global health through the study of inflammation and gene expression profiling for pediatric SLE patients in varied cohorts around the world.

According to her NIAMS/NIAMS bio, Dr. Lewandowski received her undergraduate degree from the College of the Holy Cross and her medical degree from Pennsylvania State University College of Medicine. She completed pediatric residency training at University of Massachusetts Medical Center, where she also served as a chief resident in pediatrics, developing a program in global health training.

Dr. Lewandowski completed a combined 4-year pediatric rheumatology/global health fellowship at Duke University Medical Center, during which she characterized a pediatric lupus patient cohort in South Africa. She holds a masters degree in global health from Duke University. While at Duke, Dr. Lewandowski was awarded a Fogarty Vanderbilt-Emory-Cornell-Duke (VECD) Global Health Fellowship and a Lupus Foundation Gary S. Gilkeson Career Development Award for her work with pediatric lupus patients in South Africa.

2014 Career Development Award Project

Project Title: PULSE: Pediatric Update on Lupus in South Africa: Epidemiology & Management

Project Summary: Although systemic lupus erythematosus (SLE or lupus) is known to be more severe in children and patients of African descent, almost no research has focused on pediatric SLE (pSLE) in Africa. We assembled the largest database of pSLE patients ever reported in South Africa (SA), having recruited 75 children and adolescents.

Preliminary data analysis reveals more severe disease and younger age of onset in our population compared to previous reports. Strikingly, 47% of the initial cohort presented with severe organ damage such as renal failure or stroke at diagnosis. Outcomes in South African pSLE patients may be worse due to high rates of endemic infections.

Worldwide, infections are a leading cause of morbidity and mortality in SLE patients due to altered immune responses and treatment with immunosuppressives. We hypothesize that children in SA will have increased disease severity compared to North American peers and that we will be able to identify modifiable risk factors for acquiring infections and for poor outcomes. The funding from this study enabled the lab to build a well characterized South African pSLE cohort, representing the most comprehensive assessment of pediatric SLE patients in Africa to date.

Studying SLE in a country with high HIV and TB prevalence rates allows for investigation of the interaction between SLE autoimmunity and risk for these endemic infections. Risk factors for acquiring TB may be identified, yielding data to help inform management guidelines for pSLE in TB endemic regions around the world. In addition to the information outlined above, following this cohort prospectively could offer opportunities to compare immunologic and genetic differences between populations worldwide. Altogether, this project helped build the foundation for a career in SLE clinical research with significant potential impact on the global pSLE community