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Priscilla Wong, MD

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Specialties

Allergy & Immunology

Work and Education

Professional Education

Uniformed Services University Office of the Registrar, Bethesda, MD, 5/16/2009

Residency

Madigan Army Medical Center Pediatric Residency, Tacoma, WA, 06/30/2012

Fellowship

San Antonio Uniformed Services Allergy and Immunology Fellowship, San Antonio, TX, 06/30/2015

Board Certifications

Allergy & Immunology, American Board of Allergy & Immunology

Pediatrics, American Board of Pediatrics

All Publications

A Volumetric Survey of Aeroallergens in San Antonio, Texas From 2012-2017: Not All Allergens Fit The Mold Nath, P., Gomez, R., Wong, P. H., Crisp, H. C., Adams, K. E. MOSBY-ELSEVIER. 2019: AB193
Evaluation of tryptase after subcutaneous immunotherapy-associated systemic reactions. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology Szari, S., Wong, P. H., Crisp, H. C., Champoux, E., Rans, T. S., Coop, C. A. 2019; 122 (4): 41315.e1

View details for DOI 10.1016/j.anai.2019.01.013

View details for PubMedID 30684737

Expecting the unexpected: Complement screening in the meningococcal vaccination era. The journal of allergy and clinical immunology. In practice Wong, P. H., Lee, R. U. 2019; 7 (6): 207677

View details for DOI 10.1016/j.jaip.2019.02.014

View details for PubMedID 30797079

Systemic reactions to immunotherapy during mountain cedar season: implications for seasonal dose adjustment. The journal of allergy and clinical immunology. In practice Wong, P. H., Quinn, J. M., Gomez, R. A., Webb, C. N. 2017; 5 (5): 143839.e1

View details for DOI 10.1016/j.jaip.2017.03.021

View details for PubMedID 28499782

Allergic Stomatitis From Orthodontic Adhesives. Military medicine Peterson, M. R., Wong, P. H., Dickson, S. D., Coop, C. A. 2017; 182 (3): e1883e1885

Abstract

We report a case of a type IV hypersensitivity reaction causing oral stomatitis, presumed to be the result of common dental adhesives. The case was diagnosed using patch testing to the dental adhesives that were used in the patient. Both of the adhesives tested contained a form of acrylate that is being seen more frequently in the literature as a cause of type IV hypersensitivity reactions. Metals can cause allergic reactions; however, other contact items need to be considered as a cause of oral allergic reactions. Cases of allergic stomatitis are rising and there is question if all-in-one adhesives may be contributing to this rise.

View details for DOI 10.7205/MILMED-D-16-00232

View details for PubMedID 28290980

Evaluation of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker therapy in immunotherapy-associated systemic reactions. The journal of allergy and clinical immunology. In practice Carlson, G. S., Wong, P. H., White, K. M., Quinn, J. M. 2017; 5 (5): 143032

View details for DOI 10.1016/j.jaip.2017.05.009

View details for PubMedID 28694048

Impact of Immunoglobulin Therapy in Pediatric Disease: a Review of Immune Mechanisms. Clinical reviews in allergy & immunology Wong, P. H., White, K. M. 2016; 51 (3): 30314

Abstract

Intravenous immunoglobulin (IVIG) provides replacement therapy in immunodeficiency and immunomodulatory therapy in inflammatory and autoimmune diseases. This paper describes the immune mechanisms underlying six major non-primary immunodeficiency pediatric diseases and the diverse immunomodulatory functions of IVIG therapy. In Kawasaki disease, IVIG plays a major, proven, and effective role in decreasing aneurysm formation, which represents an aberrant inflammatory response to an infectious trigger in a genetically predisposed individual. In immune thrombocytopenia, IVIG targets the underlying increased platelet destruction and decreased platelet production. Although theoretically promising, IVIG shows no clear clinical benefit in the prophylaxis and treatment of neonatal sepsis. Limitations in research design combined with the unique neonatal immunologic environment offer explanations for this finding. Inflammation from aberrant immune activation underlies the myelinotoxic effects of Guillain-Barr syndrome. HIV-1 exerts a broad range of immunologic effects and was found to decrease serious bacterial infections in the pre-highly active anti-retroviral therapy (HAART) era, although its practical relevance in the post-HAART era has waned. Clinical and experimental data support the role of immune mechanisms in the pathogenesis of childhood epilepsy. IVIG exerts anti-epileptic effects through targeting upregulated cytokine pathways and antibodies thought to contribute to epilepsy. Applications in six additional pediatric diseases including pediatric asthma, atopic dermatitis, cystic fibrosis, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS), autism, and transplantation will also be briefly reviewed. From autoimmunity to immunodeficiency, a dynamic immunologic basis underlies major pediatric diseases and highlights the broad potential of IVIG therapy.

View details for DOI 10.1007/s12016-015-8499-2

View details for PubMedID 26142065

Experience with epinephrine delivery in immunotherapy-associated systemic reactions. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology Wong, P. H., Adams, K. E., Carlson, G. S., Quinn, J. M. 2016; 116 (2): 16668

View details for DOI 10.1016/j.anai.2015.11.009

View details for PubMedID 26712521

Ovalbumin content in the yellow fever vaccine. The journal of allergy and clinical immunology. In practice Smith, D., Wong, P., Gomez, R., White, K. 2015; 3 (5): 79495

View details for DOI 10.1016/j.jaip.2015.03.011

View details for PubMedID 25912657

Isolation of bacterial cerebrospinal fluid culture contaminants at a major military medical center. Diagnostic microbiology and infectious disease Wong, P. H., Maranich, A. M., Muench, D. F. 2013; 77 (4): 35761

Abstract

In recent decades, bacterial meningitis rates have decreased secondary to the success of routine vaccinations. Ironically, the decreased incidence may contribute to the challenge of establishing accurate and timely diagnoses. Studies have suggested that in immunocompetent patients with normal cerebrospinal fluid (CSF) white blood cell counts (WBC), positive CSF cultures may be disregarded as presumed contaminants, making the initial CSF WBC increasingly relevant. This single-institution retrospective study sought to integrate clinical data with positive cultures in an era when CSF contaminants may be more commonly isolated in culture than true pathogens. A total of 7715 adult and pediatric CSF samples from 1995 to 2009 were obtained at a major military medical center. Clinical and laboratory data from 121 positive bacterial cultures were reviewed. Our bacterial CSF contamination rate (false positives) was 0.91% (70/7715). True-positive (TP) CSF cultures totaled 51 (0.66%). Among TPs, 16% (8/51) demonstrated normal CSF cell counts. The notably low 15-year CSF contamination rate of 0.91%, suggests that positive cultures are likely to represent true infection in our institution. We believe efforts to decrease the contamination rate are among the most cost-effective, while targeted clinical re-evaluation for all patients with positive CSF cultures remains vital. In light of this data, a targeted approach to re-evaluating positive cultures while incorporating the clinical context remains prudent.

View details for DOI 10.1016/j.diagmicrobio.2013.08.019

View details for PubMedID 24094835

Selective mutism: a review of etiology, comorbidities, and treatment. Psychiatry (Edgmont (Pa. : Township)) Wong, P. 2010; 7 (3): 2331

Abstract

Selective mutism is a rare and multidimensional childhood disorder that typically affects children entering school age. It is characterized by the persistent failure to speak in select social settings despite possessing the ability to speak and speak comfortably in more familiar settings. Many theories attempt to explain the etiology of selective mutism.Comorbidities and treatment. Selective mutism can present a variety of comorbidities including enuresis, encopresis, obsessive-compulsive disorder, depression, premorbid speech and language abnormalities, developmental delay, and Asperger's disorders. The specific manifestations and severity of these comorbidities vary based on the individual. Given the multidimensional manifestations of selective mutism, treatment options are similarly diverse. They include individual behavioral therapy, family therapy, and psychotherapy with antidepressants and anti-anxiety medications.Future directions. While studies have helped to elucidate the phenomenology of selective mutism, limitations and gaps in knowledge still persist. In particular, the literature on selective mutism consists primarily of small sample populations and case reports. Future research aims to develop an increasingly integrated, multidimensional framework for evaluating and treating children with selective mutism.

View details for PubMedID 20436772

View details for PubMedCentralID PMC2861522

COMPARISON OF TREATMENT RESULTS BETWEEN ADULT AND JUVENILE NASOPHARYNGEAL CARCINOMA INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS Downing, N. L., Wolden, S., Wong, P., Petrik, D. W., Hara, W., Le, Q. 2009; 75 (4): 1064-1070

Abstract

Nasopharyngeal carcinoma (NPC) has a bimodal age distribution. In contrast to the adult variant, little is known about the juvenile form. This study examined the treatment results between adult (aNPC) and juvenile NPC (jNPC) patients for future treatment considerations in jNPC.The jNPC population included 53 patients treated at two institutions between 1972 and 2004. The aNPC population included 84 patients treated at one institution. The patients had received a median dose of 66 Gy of external beam radiotherapy and 72% underwent chemotherapy. The mean follow-up for surviving patients was 12.6 years for jNPC and 6.6 years for aNPC.The jNPC patients presented with more advance stages than did the aNPC patients (92% vs. 67% Stage III-IV, p = .006). However, jNPC patients had significantly better overall survival (OS) than did aNPC patients. The 5-year OS rate was 71% for jNPC and 58% for aNPC (p = .03). The jNPC group also demonstrated a trend for greater relapse-free survival than the aNPC group (5-year relapse-free survival rate, 69% vs. 49%; p = .056). The pattern of failure analysis revealed that the jNPC patients had greater locoregional control and freedom from metastasis but the differences were not statistically significant. Univariate analysis for OS revealed that age group, nodal classification, and chemotherapy use were significant prognostic factors. Age group remained significant for OS on multivariate analysis, after adjusting for N classification and treatment.Despite more advance stage at presentation, jNPC patients had better survival than did aNPC patients. Future treatment strategies should take into consideration the long-term complications in these young patients.

View details for DOI 10.1016/j.ijrobp.2008.12.030

View details for PubMedID 19327901

Plasma osteopontin is an independent prognostic marker for head and neck cancers 41st Annual Meeting of the American-Society-of-Clinical-Oncology Petrik, D., Lavori, P. W., Cao, H., Zhu, Y., Wong, P., Christofferson, E., Kaplan, M. J., Pinto, H. A., Sutphin, P., Koong, A. C., Giaccia, A. J., Le, Q. AMER SOC CLINICAL ONCOLOGY. 2006: 529197

Abstract

To confirm the relationship between plasma osteopontin (OPN) levels and treatment outcomes in head and neck squamous cell carcinoma (HNSCC) patients in an expanded study.One hundred forty patients with newly diagnosed HNSCC were enrolled onto this study, 54 previously reported and 86 new patients. Pretreatment plasma OPN levels were assessed in all patients by an enzyme-linked immunosorbent assay method. OPN levels were correlated to treatment outcomes in the new group of patients. Detailed analyses were also performed on the relationship between OPN and tumor control rate, event-free survival (EFS), and postrelapse survival for the entire group.Using a previously defined cut off point of 450 ng/mL, there was a significant correlation between OPN and freedom-from-relapse (P = .047), overall survival (P = .019), and EFS (P = .023) in the new, independent patient cohort (n = 86). Sequence of event analyses using the entire group (N = 140) revealed that OPN was an independent prognostic factor for initial tumor control, EFS in those who have achieved tumor control, and postrelapse survival.In this expanded study, we were able to replicate the prognostic significance of OPN using a predefined cut off point in an independent patient group and demonstrated that plasma OPN is an independent prognostic marker for HNSCC.

View details for DOI 10.1200/JCO.2006.06.8627

View details for Web of Science ID 000242342800017

View details for PubMedID 17114663

Self-efficacy, coping, and difficulties interacting with health care professionals among women living with breast cancer in rural communities PSYCHO-ONCOLOGY Collie, K., Wong, P., Tilston, J., Butler, L. D., Turner-Cobb, J., Kreshka, M. A., PARSONS, R., Graddy, K., Cheasty, J. D., Koopman, C. 2005; 14 (10): 901-912

Abstract

This study examined self-efficacy, coping, and social support in relation to difficulties interacting with physicians and nurses among women living with breast cancer. One hundred women living in rural, mountainous communities of northeastern California were recruited, with 89 providing complete data for this study. All women completed a battery of questionnaires that included the CARES--Medical Interaction Subscale and measures of self-efficacy, coping, satisfaction with social support, and demographic and medical characteristics. In a multiple regression analysis, difficulties interacting with medical professionals were found to be greater among women who were not married, who used more behavioral disengagement or less self-distraction to cope with breast cancer, and who reported less self-efficacy for affect regulation and for seeking and understanding medical information. Emotional venting and satisfaction with social support for dealing with cancer-related stress were not, however, significantly related to difficulties in interacting with the medical team. This model accounted for an adjusted value of 42% of the variance. Further research is needed to identify possible causal relationships related to these findings and to determine what interventions might be warranted to improve medical interactions for women with breast cancer living in rural areas.

View details for DOI 10.1002/pon.944

View details for Web of Science ID 000232666600017

View details for PubMedID 16200526

A comparison study of different PCR assays in measuring circulating plasma Epstein-Barr virus DNA levels in patients with nasopharyngeal carcinoma CLINICAL CANCER RESEARCH Le, Q. T., Jones, C. D., Yau, T. K., Shirazi, H. A., Wong, P. H., Thomas, E. N., Patterson, B. K., Lee, A. W., Zehnder, J. L. 2005; 11 (16): 5700-5707

Abstract

To compare the performance of three PCR assays in measuring circulating Epstein-Barr virus (EBV). DNA levels in nasopharyngeal carcinoma patients and to confirm its prognostic significance.Plasma from 58 newly diagnosed nasopharyngeal carcinoma patients were collected before, during, and every 3 to 6 months after radiotherapy. EBV DNA levels were determined by real-time quantitative PCR using primer/probe sets for polymerase-1 (Pol-1), latent membrane protein 2 (Lmp2), and BamHI-W. Pretreatment levels from the three assays were correlated with each other and serial measurements from the Pol-1 assay were correlated with clinical variables.Pol-1 was more accurate than BamHI-W in predicting EBV DNA concentrations in cell lines. Of the three assays, BamHI-W yielded the highest concentrations followed by Pol-1 in plasmas (n = 23). The correlation coefficient was 0.99 (P < 0.0001) for Pol-1 and Lmp2, 0.66 (P < 0.0001) for Pol-1 and BamHI-W, and 0.55 (P < 0.0001) for BamHI-W and Lmp2. Elevated pretreatment DNA levels as detected by Pol-1 were correlated with advanced nodal stage (P = 0.04) and overall stage (P = 0.028). There was no correlation between pretreatment EBV DNA levels and freedom-from-relapse or overall survival; however, there was a significant correlation between posttreatment levels and these variables. The 2-year freedom-from-relapse and overall survival rates were 92% and 94% for patients with undetectable, and 37% and 55% for those with detectable, posttreatment levels (P < 0.0001 and P < 0.002).The three PCR assays yielded similar results in detecting EBV DNA in plasmas. The Pol-1-detected posttreatment EBV DNA level was the strongest predictor for treatment outcomes.

View details for DOI 10.1158/1078-0432.CCR-05-0648

View details for PubMedID 16115906