Pediatric Rheumatology Specialist, Neenah Grade PA-C

Our Physician Assistant Neenah, is our pediatric rheumatology specialist, together in consultation with Dr. Shikhman we have developed protocols specific to pediatric infections and autoimmune conditions.


The most common conditions we treat:

Pediatric Inflammatory Joint Pain
When children have continuous chronic musculoskeletal pain, there may be an underlying systemic problem that needs to be determined. Through a complete physical examination and laboratory findings a protocol will be developed that specifically addresses the needs of your child.

Celiac Disease and Gluten Sensitivity
If your child has celiac disease, consuming gluten will cause damage to the lining of your child's small intestines. Celiac disease is a life-long condition, but it is manageable through permanent modifications to their diet. The side effects often associated with children and celiac disease will be fully discussed and included as a part of treatment.

Autoimmune Thyroid Conditions
In kids, hypothyroidism, which occurs when the thyroid gland is underproducing thyroid hormone, is more common than hyperthyroidism, a condition in which the thyroid gland produces too much thyroid hormone. Both can produce consequences that affect your child's growth, health, mood, and ability to concentrate and learn.

Lyme disease and Coinfections
Lyme disease is a condition mainly spread by the bite of a tick. If left untreated, Lyme disease can develop into chronic lyme creating fatigue, joint pain, and brain fog. Specific co-infections may require different therapy from classical Lyme disease treatment. Many times patients suffering from a co-infection are frequently labeled with ‘resistant Lyme disease’ because they are getting treated for Lyme disease, but they are not getting treated for the co-infection.

PANS/PANDAS
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a clinical diagnosis given to children who have a dramatic – almost overnight – develop an onset of neuropsychiatric symptoms. Within 2 to 3 days neuropsychiatric symptoms, specifically OCD and/or tics (involuntary, purposeless movements), uncontrollable emotions, irritability, anxiety and poor academic performance and deterioration in handwriting skills. PANS is thought to be triggered by an environmental stressor, often an infection. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection) is thought to be triggered by a Streptococcal infection.

Parasite and other gut bacterial infections
There are several different kinds of gut bacterial infections, most commonly acquired via contaminated food or water. We routinely check for different bacteria including E. coli, campylobacter jejuni, H. pylori, among many others. Another issue we watch out for are parasites including blastocystis hominis, giardia, and various roundworms or tapeworms.

Systemic Lupus Erythematosus
Learning about treatments, taking medications as prescribed, following up with doctor’s appointments, and getting blood tests are very important to controlling lupus. Evaluating the response to treatment, and adjusting treatment with regular clinic visits.

If you are looking for a pediatric rheumatology specialist in San Diego, reach out to us to get to the bottom of your child's issues and start feeling better.




GLUTEN-FREE REMEDIES™ are food supplements and herbs selected by Dr. Shikhman and specially manufactured for the Institute for Specialized Medicine. Learn more.

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