The National Institutes of Health (NIH) announced a new clinical research program that will aim to provide answers to patients with mysterious conditions that have long eluded diagnosis.

Called the Undiagnosed Diseases Program, the trans-NIH initiative will focus on the most puzzling medical cases referred to the NIH Clinical Center in Bethesda, Md., by physicians across the nation.

"A small number of patients suffer from symptoms that do not correspond to known conditions, making their care and treatment extraordinarily difficult. However, the history of biomedical research has taught us that careful study of baffling cases can provide new insights into the mechanisms of disease -- both rare and common," said NIH Director Elias A. Zerhouni, M.D., who has made a point during his six-year tenure at NIH of encouraging trans-NIH initiatives. "The goal of NIH's Undiagnosed Diseases Program is two-pronged: to improve disease management for individual patients and to advance medical knowledge in general." The new program, which got under way over the past month, is the culmination of efforts by William A. Gahl, M.D., Ph.D., clinical director at the National Human Genome Research Institute (NHGRI), part of the NIH; John I. Gallin, M.D., director of the NIH Clinical Center; and Stephen Groft, Pharm.D., director of the NIH Office of Rare Diseases (ORD). With the program infrastructure now in place, the program is ready to accept patients, the first of which is expected to be seen in July 2008
To evaluate each patient enrolled in the new program, NIH will enlist the expertise of more than 25 of its senior attending physicians, whose specialties include endocrinology, immunology, oncology, dermatology, dentistry, cardiology and genetics. Dr. Gahl, who is an expert on rare genetic diseases, will serve as director of the new program. "We have developed a stringent referral process to ensure this program deals with those cases that have truly confounded medical experts," Dr. Gahl said. "We will be very selective when it comes to patient eligibility. Our focus is strictly on conditions that have not been diagnosed."

To be considered for this NIH pilot program, a patient must be referred by a physician and provide all medical then be asked to undergo additional evaluation during a visit to the NIH Clinical Center that may take up to a week.

Two nurse practitioners will manage patient recruitment and logistics for the new program, which will utilize existing facilities and staff already at the NIH Clinical Center, NHGRI and ORD. Funding for the program includes $280,000 per year from the ORD. In organizing the Undiagnosed Diseases Program, NIH has reached out to patient advocacy groups that often serve as a source of information and support for people struggling with mysterious ailments.

For more information about the Undiagnosed Diseases Program, go to: http://rarediseases.info.nih.gov/Undiagnosed.

Physicians and patients with specific inquiries may call the NIH Clinical Center clinical information research line, at 1-866-444-8806.

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