About

Shruti S. Banugaria is an Assistant Professor of Practice in the Department of Pediatrics at Rutgers New Jersey Medical School. She holds an MBBS degree obtained in 2008 from Government Medical College Bhavnagar and is licensed to practice medicine in New Jersey. Her professional profile indicates her involvement in clinical practice within the department, and she is affiliated with University Hospital in Newark. The information provided does not include specific details about her research focus or key contributions, but her role as an assistant professor suggests a focus on clinical education and practice within pediatrics.

Research topics

• Intensive care medicine
• Medicine
• Internal medicine
• Pediatrics

Selected publications

• A COVID-19–Positive Neonate Born to a COVID-19–Negative Mother: Should Asymptomatic Newborns Be Tested?

  Consultant · 2020

  Senior authorCorresponding
  • Medicine
  • Pediatrics
  • Intensive care medicine

  COVID-19-caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-has become a global pandemic causing unprecedented disaster in both developing and developed countries.As of July 28, 2020, the Centers for Disease Control and Prevention (CDC) estimated that the total number of COVID-19 cases in the United States was approximately 4.2 million, and that the US death toll associated with COVID-19 had reached 147,672, with both numbers increasing each day. 1 As case numbers have grown, so have concerns about the effects of COVID-19 on mothers and their newborns, yet little knowledge is available regarding the infection's effect on neonates.The performance of presently available diagnostic tests for COVID-19 is also uncertain, and debate exists over whether vertical transmission from a mother to a neonate is possible.For neonates who have positive results on their initial COVID-19 test, the American Academy of Pediatrics recommends follow-up testing of combined throat/nasopharynx specimens at 48-to 72-hour intervals until 2 consecutive negative test results are obtained. 2As the COVID-19 virus is still rapidly spreading, more cases of pregnant women with suspected or confirmed infection will be seen.As a result, most health care facilities are discharging mothers and their infants earlier compared with prior usual practices in an attempt to reduce COVID-19 infection rates.Decisions must be made regarding optimum testing and management strategies.We report the management conundrum involving the case of a newborn boy whose initial nasopharyngeal test results were positive for COVID-19, born to a mother suspected to have COVID-19 but whose test results were negative. CASE REPORTA boy who had been born at 41 weeks of gestation via vaginal delivery with vacuum assistance to a 30-year-old nulliparous mother was admitted to our newborn nursery.Prior to birth, his mother had received adequate prenatal care, and all maternal laboratory test results were negative, including syphilis rapid plasma reagin, hepatitis B surface antigen, HIV, and group B streptococcus tests.At the delivery, Apgar scores were 9 and 9 at 1 and 5 minutes, respectively.The neonate was placed in the regular nursery with standard precautions and routine nursing care.The child was appropriate for gestational age, and physical examination findings were remarkable only for a cephalohematoma over the left frontoparietal region.The newborn was screened for hyperbilirubinemia, and there were no concerns.He tolerated his formula feeds without issues, and he was well-appearing overall.The child's mother developed a fever a few hours after having given birth.Due to the present epidemiology of SARS-CoV-2, a nasopharyngeal swab was sent to detect the virus.Once the mother was tested and became a person under investigation (PUI), both the mother and the newborn were moved to a negative-pressure isolation room.While in isolation, the mother and newborn were allowed to be in the same room, at least 6 feet apart, while awaiting test results.Strict isolation measures were instituted; full personal protective equipment (PPE) had to be worn by all staff providing care to the mother and newborn.Access to the room was kept to a minimum.Aside from fever, the mother denied having any other COVID-19-related symptoms such as dyspnea, cough, chest

  PublisherDOI

• Neuroimaging findings in infantile Pompe patients treated with enzyme replacement therapy

  Molecular Genetics and Metabolism · 2017-10-14 · 62 citations

  articleOpen access
  PublisherOA PDFDOI

• Neuroimaging findings in infantile Pompe patients treated with enzyme replacement therapy

  Molecular Genetics and Metabolism · 2016-02-01 · 1 citations

  article
  PublisherDOI

• Kaplan-Meier survival curve showing comparison of ventilator-free survival CRIM-negative (CN) ERT monotherapy (n = 11) versus CN ERT+ITI (n = 7) treated patients.

  Figshare · 2015-12-02

  paratextOpen access1st authorCorresponding

  <p>*Three patients in the CN ERT+ITI group began the study invasively ventilated, became ventilator-free with treatment, and are currently still alive and ventilator-free. In contrast, all CN patients in ERT monotherapy treated group were invasive ventilator-free at baseline. This observation suggests that in some cases ERT+ITI can even reverse ventilator dependence in CN Pompe patients.</p>

  PublisherDOI

• The Use of a Reduced-Intensity Conditioning (RIC) Regimen in Patients Ages 2-30 Undergoing Allogeneic Transplantation for Sickle Cell Disease

  Biology of Blood and Marrow Transplantation · 2015-01-22 · 1 citations

  articleOpen access1st authorCorresponding

  Sickle cell disease (SCD) affects 72,000 individuals in the United States and causes considerable morbidity and mortality. Hematopoietic stem cell transplantation (HSCT) is the only cure for patients with SCD. Multiple studies show matched sibling transplants after myeloablative (MAB) conditioning have acceptable results, but with potential long-term complications, like endocrine and fertility issues. Only 14% of SCD patients will have acceptable sibling donors, and results have been less promising with higher rates of transplant related mortality (TRM) using alternative donors after MAB conditioning. Historically, only pediatric patients were considered candidates for HSCT, but a recent study demonstrated that young adult SCD patients may be able to tolerate a RIC HSCT with minimal complications. In an attempt to minimize the risk of TRM while still maximizing the available donors, this study examines the use of a RIC regimen for either matched sibling or alternative donor HSCT in SCD patients ages 2-30. Patients were deemed eligible for matched sibling HSCT if they had SCD, and for alternative donor HSCT if they had SCD with severe features with a 9-10/10 unrelated donor or 5-6/6 UCB in the donor registry. The conditioning regimen consisted of Alemtuzumab, Fludarabine, and Melphalan. Post-HCST, donor chimerism and hemoglobin S (HbS) percentages were followed closely, and there was strict monitoring for post-HSCT complications, including graft rejection, graft vs. host disease (GVHD), infectious complications, and other post-HSCT issues. 11 patients (8 related donors, 3 unrelated donors) with median age of 8.1 years (range: 2.3-23 years) were enrolled. For related HSCT, the probabilities of primary neutrophil & platelet engraftment, grade II-IV acute GVHD, chronic GVHD, and graft rejection were 100%, 27%, 12.5%, and 0%, respectively. Donor chimerisms ranged from 96-100% with HbS% between 0-43%, with median follow-up of 19 months (range: 3-24 months). Probability of 1-yr DFS and OS were 100% & 100%. For alternative donor HSCT, the probabilities of primary neutrophil & platelet engraftment, grade II-IV GVHD, chronic GVHD, and graft rejection were 100%, 33%, 33%, and 33%, respectively. Donor chimerisms ranged from 0-100% with HbS% between 0-18%, with median follow-up of 8 months (range: 2-25 months). Probability of 1-yr DFS and OS were 33% & 66%. Our results show that this RIC regimen followed by matched sibling HSCT is well tolerated, but the results were discouraging for alternative donor HSCT. Because of this, we are currently developing a protocol using post-transplant cyclophosphamide in alternative donor HSCT for SCD.

  PublisherDOI

• Non-depleting anti-CD4 monoclonal antibody induces immune tolerance to ERT in a murine model of Pompe disease

  Molecular Genetics and Metabolism Reports · 2014-01-01 · 14 citations

  articleOpen access

  Approximately 35-40% of patients with classic infantile Pompe disease treated with enzyme replacement therapy (ERT) develop high, sustained antibody titers against the therapeutic enzyme alglucosidase alfa, which abrogates the treatment efficacy. Induction of antigen-specific immune tolerance would greatly enhance ERT for these patients. Here we show that a short-course treatment with non-depleting anti-CD4 monoclonal antibody successfully induced long-term ERT-specific immune tolerance in Pompe disease mice. Our data suggest an effective adjuvant therapy to ERT.

  PublisherDOI

• Enhanced Efficacy from Gene Therapy in Pompe Disease Using Coreceptor Blockade

  Human Gene Therapy · 2014-11-08 · 29 citations

  articleOpen access

  Enzyme replacement therapy (ERT) is the standard-of-care treatment of Pompe disease, a lysosomal storage disorder caused by deficiency of acid α-glucosidase (GAA). One limitation of ERT with recombinant human (rh) GAA is antibody formation against GAA. Similarly, in adeno-associated virus (AAV) vector-mediated gene transfer for Pompe disease, development of antibodies against the GAA transgene product and the AAV vector prevents therapeutic efficacy and vector readministration, respectively. Here a nondepleting anti-CD4 monoclonal antibody (mAb) was administrated intravenously prior to administration of an AAV2/9 vector encoding GAA to suppress anti-GAA responses, leading to a substantial reduction of anti-GAA immunoglobulins, including IgG1, IgG2a, IgG2b, IgG2c, and IgG3. Transduction efficiency in liver with a subsequent AAV2/8 vector was massively improved by the administration of anti-CD4 mAb with the initial AAV2/9 vector, indicating a spread of benefit derived from control of the immune response to the first AAV2/9 vector. Anti-CD4 mAb along with AAV2/9-CBhGAApA significantly increased GAA activity in heart and skeletal muscles along with a significant reduction of glycogen accumulation. Taken together, these data demonstrated that the addition of nondepleting anti-CD4 mAb with gene therapy controls humoral immune responses to both vector and transgene, resulting in clear therapeutic benefit in mice with Pompe disease.

  PublisherOA PDFDOI

• Approach to management of cross-reactive immunologic material (CRIM)-negative infantile pompe patients treated with ERT: Role of immune modulation in changing the natural history

  Molecular Genetics and Metabolism · 2013-01-26 · 1 citations

  article1st authorCorresponding
  PublisherDOI

• Algorithm for the Early Diagnosis and Treatment of Patients with Cross Reactive Immunologic Material-Negative Classic Infantile Pompe Disease: A Step towards Improving the Efficacy of ERT

  PLoS ONE · 2013-06-25 · 110 citations

  articleOpen access1st author

  OBJECTIVE: Although enzyme replacement therapy (ERT) is a highly effective therapy, CRIM-negative (CN) infantile Pompe disease (IPD) patients typically mount a strong immune response which abrogates the efficacy of ERT, resulting in clinical decline and death. This study was designed to demonstrate that immune tolerance induction (ITI) prevents or diminishes the development of antibody titers, resulting in a better clinical outcome compared to CN IPD patients treated with ERT monotherapy. METHODS: We evaluated the safety, efficacy and feasibility of a clinical algorithm designed to accurately identify CN IPD patients and minimize delays between CRIM status determination and initiation of an ITI regimen (combination of rituximab, methotrexate and IVIG) concurrent with ERT. Clinical and laboratory data including measures of efficacy analysis for response to ERT were analyzed and compared to CN IPD patients treated with ERT monotherapy. RESULTS: Seven CN IPD patients were identified and started on the ITI regimen concurrent with ERT. Median time from diagnosis of CN status to commencement of ERT and ITI was 0.5 months (range: 0.1-1.6 months). At baseline, all patients had significant cardiomyopathy and all but one required respiratory support. The ITI regimen was safely tolerated in all seven cases. Four patients never seroconverted and remained antibody-free. One patient died from respiratory failure. Two patients required another course of the ITI regimen. In addition to their clinical improvement, the antibody titers observed in these patients were much lower than those seen in ERT monotherapy treated CN patients. CONCLUSIONS: The ITI regimen appears safe and efficacious and holds promise in altering the natural history of CN IPD by increasing ERT efficacy. An algorithm such as this substantiates the benefits of accelerated diagnosis and management of CN IPD patients, thus, further supporting the importance of early identification and treatment initiation with newborn screening for IPD.

  PublisherOA PDFDOI

• Letter to the Editors: Concerning “CRIM‐negative Pompe disease patients with satisfactory clinical outcomes on enzyme replacement therapy” by Al Khallaf et al

  Journal of Inherited Metabolic Disease · 2013-07-25 · 7 citations

  letter
  PublisherDOI

Frequent coauthors

• Priya S. Kishnani

  Duke Medical Center

  26 shared

• Sean N. Prater

  Duke Medical Center

  15 shared

• Amy S. Rosenberg

  Providence College

  12 shared

• Deeksha Bali

  Duke University Health System

  8 shared

• Trusha Patel

  Children's Hospital of Philadelphia

  8 shared

• Joanne Mackey

  Duke University

  6 shared

• Dwight D. Koeberl

  Duke Medical Center

  5 shared

• Raymond Wang

  University of California, Irvine

  5 shared

Education

• Other

  Government Medical College Bhavnagar

  2008