Overview

The Department of Clinical Immunology and Rheumatology at Nizam’s Institute of Medical Sciences (NIMS), Hyderabad, was founded on 10 April 2001 by Prof. G. Narsimulu, within one of India’s leading public tertiary-care institutes (NIMS, established 1961). Prof Liza Rajasekhar, current Head of Department  succeeded him in 2011. The Department offers integrated care for autoimmune, autoinflammatory and immunodeficiency disorders, combining a 34-bed dedicated ward, day-care and outpatient services, an in-house immunology laboratory, DM training in Rheumatology, and an active programme of clinical and multicentre research.

Milestones

• The department was founded 10 April 2001 by Prof. G. Narsimulu.

• NIMS was the first institute in India to introduce a DNB in Rheumatology (2005), later replaced by the DM programme as the main training route.

• DM Rheumatology (Clinical Immunology & Rheumatology) has run since 2010 (first batch); 44 residents have graduated to date.

• The department hosts the FPID-NIMS Regional Diagnostic Center for Primary Immunodeficiencies, part of the Foundation for Primary Immunodeficiency Diseases network in India.

Clinical services

The department manages the full spectrum of adult and paediatric rheumatic disease, including systemic lupus erythematosus and lupus nephritis, neuropsychiatric lupus, inflammatory myopathies, systemic vasculitis, scleroderma, IgG4-related disease, rheumatoid arthritis, spondyloarthritis, juvenile idiopathic arthritis and autoinflammatory syndromes, with particular depth in rare and complex autoimmune disease. Inpatient care is provided on a dedicated 34-bed ward, with intensive-care support from beds shared across the institute.

Outpatient and inpatient workload

Speciality clinics

Day-care infusions and procedures

Biologic infusions in 2025 included IV cyclophosphamide/zoledronic acid (843), rituximab/tocilizumab/infliximab (543), adalimumab/golimumab/etanercept (197) and tocilizumab (5); in 2026 (till 26 Sep), rituximab/tocilizumab/infliximab (839), adalimumab/golimumab/etanercept (213) and cyclophosphamide/zoledronic acid (644). Biopsies in 2025 spanned skin (231), kidney (145) and salivary gland (51); in 2026 (till 26 Sep), skin (155), kidney (127) and salivary gland (48).

Immunology laboratory (under the Department of Microbiology)

• Catchment area and Aarogyasri / subsidised care and CMRF are available

Primary immunodeficiency services

Primary immunodeficiency (PID) care is a distinctive strength of the department. NIMS is a designated FPID regional diagnostic centre, directed by Prof. Liza Rajasekhar, and faculty evaluate children and adults with recurrent or unusual infections, early-onset or refractory autoimmunity, and suspected inborn errors of immunity. Cases with autoimmunity as the presenting feature, such as early-onset or monogenic lupus and interferonopathies, are worked up with genomic testing, linking rheumatology and clinical immunology in a single service.

• Diagnostic evaluation:  immunoglobulin and lymphocyte-subset testing, flow cytometry (under Pathology and Medical Research Unit ), functional assays, genetic / exome testing and partner laboratories.

• Treatment and follow-up: immunoglobulin replacement through industry sponsored trials, and in select cases through the National programme for rare diseases, referral for HSCT or immunoglobulins.

• Network and teaching: dedicated FPID-funded project to establish the foundations of PID care.  PID registry, ISPID collaborations.

Training and academics

The department has 4 DM seats per year in Rheumatology (Clinical Immunology & Rheumatology). The programme has run since 2010 (first batch), producing 44 graduates to date. [ADD: alumni positions, fellowships, observerships]

Research

Departmental research spans lupus (including lupus myelitis, interferon-α as a marker of severe disease, and lupus nephritis), inflammatory myopathies and classification criteria, vasculitis (Takayasu arteritis), IgG4-related disease, and primary immunodeficiency, alongside national guideline development (IRA, MyoIN) and multicentre and industry-sponsored trials. Over 30 peer-reviewed publications have come out of the department in the past three years.

Current / Recent Sponsored and academic clinical trials

Other academic research projects

• Effectiveness of an individualised home exercise programme on muscle strength and endurance in idiopathic inflammatory myopathies (RCT)

• Withdrawal of immunosuppressive therapy or glucocorticoids in stable, non-renal systemic lupus erythematosus (open-label RCT)

• Microvascular complement deposition in non-lesional skin as a biomarker of disease activity in SLE

• Role of maternal serum placental factors (sFlt-1, PlGF) in predicting adverse pregnancy outcomes in SLE

• Tofacitinib versus adalimumab in axial spondyloarthritis (single-centre prospective observational study)

• Methotrexate with hydroxychloroquine versus methotrexate alone in treatment-naïve rheumatoid arthritis (open-label RCT)

Selected recent publications

• Faghihi-Kashani S, et al. (Rajasekhar L, contributing author). Clinical characteristics of anti-synthetase syndrome: analysis from the CLASS project. Arthritis Rheumatol. 2025;77(4):477–489.

• Saygin D, et al. (Rajasekhar L, contributing author). Item selection for a revised classification criteria for adult and juvenile idiopathic inflammatory myopathies: MyoROC project. Semin Arthritis Rheum. 2025;74:152822.

• Baisya R, Yerram KV, Murthi GSR, Appani SK, Devarasetti PK, Rajasekhar L. Decade-long study on phenotype and prognosis of lupus myelitis in SLE: insights from a single centre in India. Eur J Rheumatol. 2025;12(1):1–7.

• Yerram KV, Baisya R, Kumar P, Mylavarapu R, Rajasekhar L. Serum interferon-alpha predicts in-hospital mortality in patients hospitalised with acute severe lupus. Lupus Sci Med. 2023;10(2):e000933.

• Kumar SA, Srivastava MK, Sree Lekha K, Madhuri C, Kumar P. Intracranial and extracranial vascular involvement in Takayasu arteritis unresponsive to multiple lines of immunomodulation on 68Ga-FAPI PET/CT. Clin Nucl Med. 2025.

• Mohanty MC, et al. (Rajasekhar L, contributing author). Assessment of enterovirus excretion and identification of VDPVs in patients with primary immunodeficiency in India: ICMR–WHO collaborative study, Phase I. Vaccines. 2023.

[Full publication list for 2023–2025 available as an annex, if required]

Faculty

 Three non-DM senior residents and research scientist also are part of the team]

Contact

Department of Clinical Immunology and Rheumatology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana.

• OPD: Monday to Friday, 8:00 AM – 4:00 PM

• Email: nimsrhoff@gmail.com ( office), nimsrhopd@gmail.com (opd)

• Phone: 040-2348-9412, 9410