I am a dedicated fellowship-trained physician who is double board certified in Internal Medicine and Allergy/ Immunology. I am cross-trained in both pediatric and adult Allergy/ Immunology. My areas of expertise include food allergy, chronic urticaria and angioedema, but I also enjoy general Allergy/ Immunology. One of my favorite aspects of Allergy/ Immunology is the wide applicability to the general population and the ability to address the significant impact that allergies can have on people’s quality of life and productivity. I have trained and worked in a broad range of clinical care settings, including private practice, the VA, Kaiser and academia. My experience allows me to bring a unique perspective and skill set that incorporates the best of these practice models. I also bring significant clinical research experience that expands study start-up to manuscript preparation. I am fundamentally driven by a desire to help people and to provide quality care. I pride myself in both patient satisfaction and efficiency, as my work style is detail and process oriented. I grew up in San Francisco and am grateful to have settled back in the Bay Area.
- Allergy and Immunology
Clinical Assistant Professor, Medicine
Board Certification: Allergy and Immunology, American Board of Allergy and Immunology (2018)
Fellowship: UCSD Allergy and Immunology Fellowship (2018) CA
Board Certification: Internal Medicine, American Board of Internal Medicine (2016)
Residency: UCLA Medical Center Internal Medicine (2016) CA
Medical Education: University of California at San Francisco School of Medicine (2013) CA
Radiation recall dermatitis triggered by prednisone.
2020; 105 (6): E16–E18
View details for PubMedID 32716998
- Conflicting verdicts on peanut OIT from the ICER and FDA Advisory Committee; where do we go from here? The Journal of allergy and clinical immunology 2019
Analysis of Allergen-Specific T Cell and IgE Reactivity to Different Preparations of Cow's Milk-Containing Food Extracts
2019; 8 (7)
cow's milk allergy (CM) is among the most common food allergies in young children and is often outgrown by adulthood. Prior to developing a tolerance to CM, a majority of CM-allergic children may tolerate extensively-heated CM. This study aims to characterize the IgE- and T cell-reactivity to unheated CM and the progressively more heated CM-containing foods.CM-containing food extracts from muffin, baked cheese, custard and raw, pasteurized CM commercial extract were tested for skin prick test reactivity, IgE binding and T cell reactivity as assessed by IL-5 and IFNγ production.the skin prick test (SPT) reactivity was significantly decreased to muffin extract compared to raw, pasteurized CM. Both IgE- and T-cell reactivity were readily detectable against food extracts from all forms of CM. Western blot analysis of IgE reactivity revealed variability between extracts that was protein-specific. T cell-reactivity was detected against all four extracts with no significant difference in IL-5 or IFNγ production between them.our data indicate that despite reduced clinical reactivity, extracts from heated CM-containing foods retain immunogenicity when tested in vitro, particularly at the T cell level.
View details for DOI 10.3390/cells8070667
View details for Web of Science ID 000478902000060
View details for PubMedID 31269726
View details for PubMedCentralID PMC6679079
Acquired Donor Peanut Allergy From Lung Transplantation Resulting in Respiratory Failure: A Case Report
2018; 50 (10): 4085–86
This case report describes a patient who acquired a donor peanut allergy after lung transplantation. A 53-year-old woman with alpha-1 antitrypsin deficiency underwent left-sided lung transplant from a donor with a history of anaphylaxis to peanut. Two weeks after the transplant, the patient developed acute respiratory failure immediately after consuming a peanut butter and jelly sandwich. The donor's serum confirmed high titers of peanut-specific immunoglobulin E (IgE). The recipient patient had never had allergies to peanuts or other nuts before her transplant. After the transplant, she had negative serology but positive skin testing to peanuts. This case illustrates the importance of considering donor food allergies when caring for solid organ transplant recipients.
View details for DOI 10.1016/j.transproceed.2018.08.001
View details for Web of Science ID 000454972000202
View details for PubMedID 30447764
- Mast cell disorders Protean manifestations and treatment responses ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY 2018; 121 (1): 128–30
- Marijuana and stoned fruit ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY 2018; 120 (5): 536–37
Preventing Peanut Allergy
PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY
2018; 31 (1): 2–8
The rising prevalence of food allergy and specifically peanut allergy has had significant implications for affected patients, families, and society. The current standard of care remains strict avoidance and the use of emergency medications for accidental ingestions. There is recent evidence-based information to suggest that one approach to preventing peanut allergy lies in early introduction of peanut. This represents a paradigm shift from previous recommendations and has led to updated guidelines in the United States, Europe, and Australasia on the introduction of potentially allergenic foods in the infant diet. This new approach to prevention has some practical obstacles and challenges associated with its implementation. There is also growing interest in the role of maintaining a healthy skin barrier in prevention of sensitization and food allergy. Other approaches, including pro- and prebiotics, prenatal maternal dietary avoidance, breastfeeding, and the use of specific formulas, have not shown reproducibly favorable results. As children with peanut allergy are unlikely to outgrow their food allergy, early oral immunotherapy in those with established peanut allergy is being investigated with the hopes of altering the natural history of an otherwise lifelong disease.
View details for DOI 10.1089/ped.2017.0826
View details for Web of Science ID 000423131000001
View details for PubMedID 29588872
View details for PubMedCentralID PMC5867507
- Baked milk and baked egg oral immunotherapy IMMUNOTHERAPY 2017; 9 (15): 1201–4
Emerging Therapies in Hereditary Angioedema
IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA
2017; 37 (3): 585-+
Remarkable progress has been made in the treatment of bradykinin-mediated angioedema with the advent of multiple new therapies. Patients now have effective medications available for prophylaxis and treatment of acute attacks. However, hereditary angioedema is a burdensome disease that can lead to debilitating and dangerous angioedema episodes associated with significant costs for individuals and society. The burden of treatment must be addressed regarding medication administration difficulties, treatment complications, and adverse side effects. New therapies are being investigated and may offer solutions to these challenges. This article reviews the emerging therapeutic options for the treatment of HAE.
View details for DOI 10.1016/j.iac.2017.03.003
View details for Web of Science ID 000406819300012
View details for PubMedID 28687111
View details for PubMedCentralID PMC5585075
The current state of food allergy therapeutics
HUMAN VACCINES & IMMUNOTHERAPEUTICS
2017; 13 (10): 2434–42
The prevalence of IgE mediated food allergy is an increasing public health concern. The current standard of treatment is strict avoidance of the offending food(s). There are no FDA approved treatments for food allergy. This review will provide an overview of strategies currently under investigation for the treatment of food allergy. The main focus of research has been directed at various forms of immunotherapy, including oral, sublingual and epicutaneous delivery routes. While oral immunotherapy (OIT) has shown the greatest promise for efficacy in terms of amount of protein that can be ingested, it has also demonstrated less tolerability and a less favorable safety profile as compared to sublingual immunotherapy (SLIT) and epicutaneous immunotherapy (EPIT), which offers the least protection but has the best safety and tolerability profile. Investigation is also underway for modified antigens that may be used for immunotherapy and for adjuncts that may help facilitate immunotherapy, including biologics such as anti-IgE therapy, and also probiotics. There are also a number of preclinical concepts that are being evaluated to manipulate the antigens and/or the immune system that may one day be translatable to patients.
View details for Web of Science ID 000415981300041
View details for PubMedID 28846472
View details for PubMedCentralID PMC5647972
- Elevated Lactate Levels in a Non-Critically Ill Patient JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 2015; 313 (8): 849–50
Voriconazole Antifungal Prophylaxis After Lung Transplantation And Risk Of Squamous Cell Carcinoma Of The Skin
AMER THORACIC SOC. 2015
View details for Web of Science ID 000377582800432