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Primary Immune Regulatory Disorder (PIRD) Clinic

The Pediatric Primary Immune Regulatory Disorder (PIRD) Clinic cares for children with complex immune system problems that have a genetic cause. The label PIRD covers a diverse group of rare disorders in which the immune system malfunctions – it is overactive, underactive or doesn’t respond appropriately to challenges.

Depending on the particular genetic mutation, a child with PIRD may develop an autoimmune disorder, a condition in which the immune system attacks healthy tissues; hyperinflammation or autoinflammation, in which the immune system overreacts or reacts without cause; severe allergies; or other conditions in which key immune cells aren’t functioning properly. These conditions usually become apparent in the first years of life and they are difficult to treat, leaving patients vulnerable to disability and death.

Our goal at the PIRD Clinic is to change the common course for these diseases. Directed by Dr. Alice Chan, an expert on PIRD, our team of pediatric specialists works to determine the underlying genetic cause of each patient’s condition. Once we have this diagnosis, we can design a therapy that precisely targets the defective immune system pathway. For example, if our genetic testing shows a defect in the gene that makes CTLA4, an important protein for controlling the immune system, we can treat the patient with a drug that delivers this protein.

For some children with PIRD, the best treatment is a stem cell transplant. In these cases, we collaborate with the team at the UCSF Blood & Marrow Transplant (BMT) Clinic. Finding the best option for each child and family is part of our mission to bring the best care to children with PIRD.

Our locations (1)

    Awards & recognition

    • Ranked among the nation's best in 10 specialties

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    Preparing for your appointment

    What to Bring

    • Photo I.D.
    • Health insurance card
    • Insurance authorization, if required
    • Doctor's referral, if required
    • Recent test results related to your child's condition
    • List of medications, including dosages, plus any your child is allergic to
    • Immunization record
    • List of doctors and locations seen in the past
    • List of questions you may have
    • Device or paper for taking notes

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    Your Stay

    We offer valuable information to help you plan for your child's upcoming hospital stay. Find out about food services, family accommodations and more.

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    Your Child's Care Team

    Our doctors, nurses, child life specialists and other providers have special training to care for children. Meet your child's care team.

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    Interpreter Services & Communication Assistance

    Interpreter services in many languages and TDDs are available for families that need help communicating with care teams. Here's how to access them.

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    Support services

    Child Life Services

    Activity rooms, pet therapy and more to help kids feel at home.

    Child Life

    Certified child life specialists ease the stress and anxiety of childhood illness through therapeutic play, schooling and family-focused support.

    Family Amenities

    Family-friendly amenities help you relax and take care of yourself while staying close to your child. We offer lounges, kitchens, showers, breastfeeding rooms and more.


    Social Services

    Social workers ease the effect of illness, injury and hospitalization on your family with counseling and assistance to help you navigate the challenges.


    Activity Rooms

    Activity rooms offer a relaxed environment for children of all ages. Features include a playroom, digital arts studio and teen lounge. Find out more.


    Art Therapy

    Art therapy helps kids and families express themselves, making it easier to cope with pediatric health issues. Group and bedside services are available.


    Music Therapy Program

    Board-certified music therapists help kids cope with illness and the feelings that come with it. Find out about group activities and bedside therapy.


    School Program

    Our schoolroom services and individual learning programs help children hospitalized at UCSF continue their education and get ready to return to school.


    School Re-Entry Program

    After hospitalization, we help kids return to school by educating staff and students about their needs and recommending needed accommodations. Read more.


    Individual Playtime & Instruction

    If your child can't be around other kids for medical reasons, you can sign up for private sessions in our activity and school rooms. Find out how.


    Interpreter Services & Communication Assistance

    Interpreter services in many languages and TDDs are available for families that need help communicating with care teams. Here's how to access them.

    Family Resource Center

    We help families cope with the challenges of childhood illness and hospitalization in a relaxing environment where parents can get a much-needed break.


    Parent Support Program

    Weekly activities, including knitting, scrapbooking, chair massage and more, help family caregivers get a much-needed break. Find out more.


    Patient Relations

    Patient relations reps and nursing supervisors are here to answer questions and address concerns. Learn about your rights, how to reach us and more.


    Spiritual Care

    Chaplains help UCSF patients, families and staff cope with the spiritual and emotional challenges of childhood illness. Learn more.


    International Services

    If you're coming to UCSF from outside the U.S., we coordinate your child's appointments and provide other helpful services. Here's how to get started.

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    Wander outside into our Butterfly Garden in Oakland and our healing gardens at Mission Bay.