Immunology & Allergy

Adelle Atkinson, MD
Eyal Grunebaum, MD
Chaim Roifman, MD 
Vy Kim, MD
Julia Upton, MD

At the most extreme end of inherited primary immunodeficiencies are children with Severe Combined Immunodeficiency (SCID). These children have a complete absence of both T and B lymphocyte function, which is essential to lead a normal life. The absence of these types of functional white blood cells puts the very young child at risk for serious life-threatening infections, specifically opportunistic pathogens such as fungus, viruses and pneumocystis jiroveci pneumonia (PJP).

Clinically, these young infants have recurrent severe infections, failure to thrive, diarrhea and sometimes skin rashes. Treatment options for SCID are currently limited to bone marrow transplantation, which involves infusing stem cells from a healthy donor who matches the patient. These transplants are either full-matched sibling transplants or matched unrelated donor transplants.

The BMT Program for primary immunodeficiencies at SickKids is the only one of its kind in Canada. It is a leader in the field of Transplantation for SCID both in Canada and around the world. In the late 1970s the first national transplant for primary immunodeficiencies was performed here, and since that time approximately 50 or more similar transplants have been performed. This is an extremely significant number given the rarity of these conditions.  

The first national matched unrelated donor transplant was also executed at SickKids in 1990 in a patient with Omenn’s Syndrome, and since then SickKids holds the highest survival rate for these transplants at 77 per cent compared to 61 per cent in European centres. This transplant program provides care to children all across Canada with a wide variety of immunodeficiencies such as IL-2R deficiency and ADA deficiency, and many types of autosomal recessive and X-linked diseases.

Both before during and after the actual Bone marrow transplant, the SickKids Immunology Team is very involved with each patient and their family in terms of locating a potential donor and devising a plan of care. After the transplant, the Immunology Team follows the patient very closely to provide complex post-transplant care. With a true "bench to bedside" approach to patient care, this program provides genetic diagnoses and outstanding therapeutic practices/clinical care for these patients, while adding to the growing body of knowledge about patients with these inherited disorders.

Chaim Roifman, MD
Eyal Grunebaum, MD
Julia Upton, MD
Vy Kim, MD
Jessica Willett-Pachul, RN, MN

There are a number of inherited disorders of the immune system that are characterized by patients lacking the ability to produce antibodies. Patients with documented antibody deficiency syndromes are enrolled into the gammaglobulin treatment program at SickKids. Once stable on therapy, patients may receive their treatment in a community hospital that is closer to home and be monitored by a community care physician.

The program team consists of a clinical nurse specialist and clinical immunologists/allergists. They monitor the patients’ laboratory results from the community and assess the patients at routine clinic appointments at SickKids. The Immunology Team is always available for consultation to the patients and physicians in the community. This treatment model allows for patients to have the expertise of the SickKids team, while at the same time allowing for care to be delivered in a convenient location for patients and families.

Patients in the program are also monitored for infections by history, pulmonary function tests, and CT scans of their lungs to determine if lung disease develops. As well, liver function tests and viral screening are performed to monitor the safety of gammaglobulin therapy, by screening for possible viral transmission through the blood product. With a long-term follow-up on over 150 patients, the Hypogammaglobulinemia Program at SickKids is one of the largest treatment programs for this patient group in the world. In being viewed as world leaders in the management and treatment of hypogammaglobulinemia, Dr. Roifman and the Clinical Team involved in this program have been invited to participate in National and International Consensus Conferences on patient management of hypogammaglobulinemia and gammaglobulin therapy.

Eyal Grunebaum, MD
Adelle Atkinson, MD
Vy Kim, MD
Julia Upton, MD
Carmen Riggioni, MD
Peter Vadas, MD

Launched in 2013 by Dr. Eyal Grunebaum, the SickKids Food Allergy and Anaphylaxis Program (FAAP) is leading the development of breakthrough research to progress the field of food allergy.

This includes conducting immunological research to understand the mechanisms of food allergy and anaphylaxis for prevention and treatment, performing clinical trials to evaluate treatment options for milk, peanut, and tree nut allergies, and providing educational activities for patients and health care providers. An additional goal of the FAAP team is promoting public awareness of food allergies. The main vision of the SickKids FAAP team continues to be a future without the fear of food.

Chaim Roifman MD
Harjit Dadi PhD 

Diagnostic information for patients with primary immunodeficiencies (PIDs) in Ontario and across Canada will be provided via techniques such as protein identification, cloning and sequencing, and a state-of-the-art flow cytometry facility. This strictly pertains to service rendered for already known entities. As new types of PIDs are discovered, the service will adapt quickly and implement accurate and reliable tests. This facility currently includes a modernized immunology service laboratory, located near relevant research activities to their mutual benefit.

• Eyal Grunebaum
• Chaim Roifman
• Adelle Atkinson
• Julia Upton
• Vy Kim
• Ori Scott
• Carmen Riggioni

• Maria Asper 
• David Hummel
• Audrey Segal
• Lucy Duan

• Jessica Willett Pachul (Clinical Nurse Specialist) 
• Myra Pereira (Clinical Nurse Specialist)
• Anna Kasprzak (Registered Nurse)
• Maricelle Tia (Registered Nurse)
• Wendy Shama (Social Worker) 

• Abdulrahman Al Ghamdi
• Azhar Al Shaqaq
• Ashna Asim
• Kristin Hunt
• Yousef Alabdeen
• Netusha Thevaranjan

SickKids, located in Toronto, Ontario, Canada and affiliated with the University of Toronto, is Canada's largest and one of the world’s leading paediatric academic health- care institutions.  

As innovators in child health, SickKids improves the health of children by integrating care and research. SickKids is one of only two centres in Canada that has been designated as a World Allergy Organization (WAO) Center of Excellence, which recognizes the innovative clinical, educational, and research work that is performed by the clinicians and scientists within the Division of Allergy & Immunology.  

The Allergy Clinic is a referral clinic for the diagnosis and management of children with complex allergic diseases including multiple food allergies and patients with complex medical conditions followed by SickKids who require an allergy assessment. The clinic provides allergy consultations, testing, and challenges as needed.  

The Food Immunotherapy Clinic offers longitudinal care and immunotherapy, which is an emerging and important treatment option for patients with food allergies. 

The fellowship offers the successful candidate the opportunity to be a fully integrated team member in the Allergy and Food Immunotherapy clinics at SickKids. The fellowship will allow the trainee to enhance their knowledge and skills in the advanced care of children with food allergy, including medically complex patients, multiple food allergies, severe atopy, advanced diagnostics, and cutting-edge treatments.  

Trainees will participate longitudinally in the Allergy and Food Immunotherapy clinics and may be required to participate in overnight, weekend and holiday calls. Clinical supervision will be provided by staff within the Division of Allergy & Immunology with regular assessments, observation and feedback provided. 

Applicants from the Paediatrics or Internal Medicine stream are welcome to apply. The fellowship accepts Canadian and international applicants, although preference will be given to Canadian applicants. 

Applicants must: 

• Be a holder of a Medical Doctor (MD) degree or equivalent 
• Have successfully completed a subspecialty residency program in Clinical Immunology & Allergy accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC) or equivalent accredited training prior to the start of the fellowship 
• Be eligible for, or have written the RCPSC subspecialty examination in Clinical Immunology & Allergy or equivalent 
• Be eligible for an educational medical license in the province of Ontario. 

Previous research or academic scholarly experience is not required but will be considered an asset. 

This position is fully funded by the Food Allergy & Anaphylaxis Program at SickKids at a rate equivalent to PGY5/6 level with benefits. 

The start date will be determined by the Food Allergy & Anaphylaxis Program. 

Interested individuals should email the following documents in PDF format to sandra.mendonca@sickkids.ca by June 30, 2024. Please address your application to Dr. Vy Kim.

• Statement of interest highlighting your reasons for applying to the fellowship
• Updated CV
• List of your credentials
• Three letters of support

Applicants will be notified if they are selected for an interview. For additional information or questions, contact Sandra Mendonca, Training Program Co-ordinator at sandra.mendonca@sickkids.ca or 416-813-8626.