CHOC Children's Clinic
1201 W. La Veta Ave.
Building: CHOC Clinic
Orange, CA 92868
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CHOC Children's Health Center - Mission Viejo
27700 Medical Center Rd
Building #2 Suite 138
Mission Viejo, CA 92691
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CHOC Children’s Specialty Center - Newport Beach
500 Superior Ave.
Newport Beach, CA 92663
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A nationally-recognized expert in pediatric hematology, Dr. Nugent's clinical and research interests include blood disorders, bone marrow failure, bleeding and clotting disorders, and white cell and immune deficiencies. She is involved in a number of clinical trials for rare blood disorders, including a study that looks at the use of Fibrogammin P, a human plasma derived Factor XIII concentrate, in patients with congenital Factor XIII deficiency. Dr. Nugent is also principal investigator for the Region IX MCHB Hemophilia Treatment Program and its associated research.
A prolific author on innovative medicine, Dr. Nugent has coauthored more than 100 journal articles and book chapters and has been featured in journals including Haemophilia, Blood, New England Journal of Medicine, Thrombosis Research and more. She specializes in all aspects of hematology, bone marrow failure, anemias, immune disorders, bleeding and clotting disorders. Specialized procedures include bone marrow biopsy, aspiration and lumbar puncture.
Dedicated to clinical excellence, Dr. Nugent is board certified in both pediatrics and pediatric hematology-oncology. Prior to joining CHOC Children's, Dr. Nugent attended medical school at the University of California, Los Angeles. Her residency and internship training were completed at Denver Affiliated Hospitals in Colorado. Dr. Nugent received her fellowship training at Children's Hospital Medical Center in Seattle and Fred Hutchinson Cancer Research Center.
A respected physician leader, Dr. Nugent was recognized as Physician of the Year in Orange County and serves as chair of review subcommittees at NHLB1/NIH and HRSA Region IX program projects in the area of hematology. Dr. Nugent speaks fluent Spanish.
Nugent DJ, Bray GL, Counts RB, Clements MJ and Thompson AR. Danazol fails to increase
factor VIII or IX levels in a double-blind crossover study of patients with haemophilia A and B .
Br J Haematol 1986; 64:493-502.
Kunicki TJ, Nugent DJ, Piotrowicz RS and Lai C-S. Covalent attachment of sulfydryl-specific, electron spin resonance spin-labels to Fab' fragments of murine monoclonal antibodies that recognize human platelet membrane glycoproteins. Development of membrane protein specific spin probes. Biochemistry 1986; 25:4979-4983.
Nugent DJ, Kunicki TJ, Berglund C and Bernstein I. A human monoclonal autoantibody recognizes a neoantigen on glycoprotein IIIA expressed on stored and activated platelets. Blood 1987; 70(1):16-22.
Bray G and Nugent DJ. Hemorrhage involving the upper airway in hemophilia . Clin Pediatr 1986; 25(9):436-439.
Kunicki TJ, Furihata K, Bull B, and Nugent DJ. The immunogenicity of platelet membrane glycoproteins. Transfus Med. Rev 1986; (1):21-33.
Shulman H, Gown AM and Nugent DJ. Hepatic veno-occlusive disease after bone marrow transplantation: Immunohistochemical identification of the material within occluded central venules. Am J Pathol 1987; 127(3):549-558.
Furihata K, Nugent DJ, Bissonette A, Aster RH and Kunicki TJ. On the association of the platelet-specific alloantigen, Pena, with glycoprotein IIIa. Evidence for heterogeneity of glycoprotein IIIa. J Clin Invest 1987; 80(6):1624-1630.
Canfield V, Ozols J, Nugent DJ and Roth G. Isolation and characterization of the and chains of human platelet glycoprotein Ib". Biochem Biophys Res Comm 1987; 147(2):526-534
Brashem-Stein C, Nugent DJ and Bernstein ID. Characterization of an antigen expressed on activated human T cells and platelets. J Immunol 1988; 140(7):2330-2333.
Odell JM, Haas JE, Tapper D and Nugent DJ. Infantile hemorrhagic angiodyplagia . Pediatr Pathol 1987; 7:(5-6)629-636.
Piotrowicz RS, Orchekowski RP, Nugent DJ, Yamada KM and Kunicki TJ Glycoprotein Ic- IIa functions as an activation-independent fibronectin receptor on human platelets . J Cell Biol 1988; 106(4):1359-1364.
Roth GJ, Ozols J, Nugent DJ and Williams SA. Isolation and characterization of human platelet glycoprotein IX. Biochem Biophys Res Commun 1988; 156(2):931-939.
Kunicki TJ, Nugent DJ, Staats SJ, Orchekowski RP, Wayner EA and Carter WG. The human fibroblast class II extracellular matrix receptor mediates platelet adhesion to collagen and is identical to the platelet glycoprotein Ia-IIa complex. J Biol Chem 1988; 263(10):4516-4519.
Kunicki TJ, Furihata K and Nugent DJ. Glycoprotein IIb-IIIa as an immunologic target. Current Studies in Hematology Blood Transfusion 1988; (54):44-63.
Nugent DJ. Human monoclonal autoantibodies to characterize platelet antigens in immune- mediated thrombocytopenia. BLUT 1989; 59(1):52-58.
Nugent DJ. Characterization of human antiplatelet autoantibodies using rabbit polyclonal and murine monoclonal anti-idiotypic antibodies. Clin Immunol and Immunopath 1990; 53:52-58.
Hiraiwa A, Nugent DJ and Milner EC. Sequence analysis of monoclonal antibodies derived from a patient with idiopathic thrombocytopenic purpura. Autoimmunity 1990; 8(2):107-113.
Kunicki TJ, Furihata K, Kekomaki R, Scott JP, and Nugent DJ. A human monoclonal autoantibody specific for human platelet glycoprotein IIb (integrinII) heavy chain. Human Anti bodies and Hybridomas 1990;1(2):83-95.
Bearman SI, Hinds MS, Wolford JL, Petersen FB, Nugent DJ, Slichter SJ, Shulman HM, and McDonald GB. A pilot study of continuous infusion heparin for the prevention of hepatic veno-occlusive disease after bone marrow transplantation. Bone Marrow Transplant 1990; 5:(6)407-411.
Kunicki TJ, Annis D, Gorski J, and Nugent DJ. Nucleotide Sequence of the Human Autoantibody 2E7 Specific for the Platelet Integrin II Heavy Chain. J Autoimmunity 1991; 4:433-446.
Nugent DJ. IVIG in the treatment of children with acute and chronic idiopathic thrombocytopenic purpura and the autoimmune cytopenias. Clinical Reviews in Allergy 1992; 10:1-14.
Nugent DJ. IVIG in the treatment of children with acute and chronic idiopathic Thrombocytopenic purpura and the autoimmune cytopenias. IVIG Therapy Today 1992; 59-71.
Kunicki TJ, Plow EF, Kekomake R and Nugent DJ. Human monoclonal autoantibody 2E7 is specific for a peptide sequence of platelet glycoprotein IIb. Localization of the epitope to IIb 231- 238 with an immuno dominant Trp235. J Autoimmunity 1991; 4(3):415-431.
Devine DV, Andestad G, Nugent DJ and Carter CJ. Platelet-associated factor XIII as a marker of platelet activation in patients with peripheral vascular disease. Arteriosclerosis & Thrombosis 1993; 13(6):857-862.
Langkamp D, Brazy J, Neary P, and Nugent DJ. Combined Rh hemolytic disease and granulocyte alloimmunization causing prolonged agranulocytosis in a newborn infant. J Perinatology 1993; 13(6):478-480.
Tarantino MD, Kunicki TJ, Nugent DJ. The estrogen receptor is present in human megakaryocytes. Ann N.Y. Acad Sci 1994; 714:293-296.
Nugent DJ Alloimmunization to platelet antigens Semin Hematol 1992; 29 (3 Suppl 2): 83-88.27.
Gruel Y, Brojer E, Nugent DJ, and Kunicki TJ. Further characterization of the thromblasthenia- related idiotype OG. Antiidiotype defines a novel epitope(s) shared by fibrinogen B chain, vitronectin, and Von Willebrand factor and required for binding to 3. Journal of Experimental Medicine 1994; 180(6):2259-2267.
Tarantino MD, Nugent DJ Severe electrical burns in a hemophiliac wearing a medical alert neck chain. Clin Pediatr (Phila) 1994 33(6): 382-383.
Ishida F., Gruel Y., Brojer E., Nugent DJ, Kunicki TJ Repertoire cloning of a human IgG inhibitor of IIB 3 function. The OG idiotype. Mol. Immunol. 1995;32(9): 613-622.
Gruel Y., Nugent D.J., Kunicki T.J.. Molecular specificity of anti IIb/IIIa human antibodies. Semin. Thromb. Hemost. 1995;21:(1) 60-67.
Imbach, P, Akatsuka J, Blanchette V, Nugent DJ Immune thrombocytopenic purpura as a model for pathogenesis and treatment of autoimmunity. Eur J Pediatr 1995 154:500 564.
Kunicki TJ, Kritzik M, Annis DS, Nugent DJ. Hereditary variation in platelet integrin 21 density is associated with two silent polymorphisms in the 2 gene coding sequence. Blood 1997 89(6):1939-1943.
Kunicki TJ and Nugent, DJ Autoantibodies and Autoantigens in Immune Mediated Thrombocytopenia. Schoenfeld, Kennedy and Ferrone (eds) In: Idiotypes in Medicine- infections, Autoimmunity and Cancer. Elsevier Science B.V.1997; 513-535.
Mammen EF, Comp PC, Gosselin R, Greenberg C, Hoots W, Kessler CM, Larkin EC, Liles D, Nugent DJ PFA-100TM system: a new method for assessment of platelet dysfunction. Seminars in Thrombosis Hemostasis 1998;24(2):195-202.
Kretz M, Savage B, Nugent DJ, Santoso S, Ruggeri ZM, Kunicki TJ. Nucleotide polymorphisms in the 2 gene define multiple allels which are associated with differences in platelet 2 1 density. Blood 1998 92(7):2382-2388.
DiPaola, J., Federici, AB, Mannucci, PM, Canciani, MT, Kritzik, M., Kunicki, TJ, Nugent, DJ Low Platelet 21 Levels in type I von Willebrand disease correlate with impaired platelet function in a high shear stress system Blood, 1999 93(11);3:578-3582.
Nugent, DJ Immune thrombocytopenic purpura: why treat J Pediatr 1999 134(1)3-4.
Buzby JS, Brewer G., Nugent, DJ, Developmental regulation of RNA transcript estabilization by A+U rich elements is AUF1 dependent. J.Biol.Chem 1999;274 (48):33973- 33978.
Nugent DJ, DiPaola J, and Kunicki, TJ Hereditary Variation of the Platelet Collagen Receptor 21 Journal of Am Soc Peds Heme Onc 2000.
DiPaola J, Nugent DJ, Young G Current Therapies in Rare Factor Disorders Haemophilia (2001), 7, (Suppl.1) 00-00
Sandborg C, Buyon JP, Nugent, DJ, Mellins E Maternal Immunological Diseases and Neonatal Disorders
Young, G, Nugent, DJ Prevention of Bleeding Complications in Neonates with Liver Failure Undergoing Surgery Using Recombinant Factor VIIa Hematology 2001; 6:341-346.
Furihata K, Nugent DJ, Kunicki TJ. Influence of platelet collagen receptor polymorphisms on risk for arterial thrombosis. Arch Pathol Lab Med. 2002 Mar; 126(3):305-9. Review
Nugent DJ. Controversies in the treatment of pediatric immune thrombocytopenias. Blood Rev. 2002 Mar;16(1):15-7.
Nugent DJ Childhood immune thrombocytopenic purpura Blood Rev.2002 Mar;16(1):27-9
Zaldivar, F., Jr, Imfeld, KL, Nugent, D.J., Berman, M.A., Identification of a Novel Regulatory Element in the Human Interleukin 1 Alpha (IL-1) Gene Promoter. Cytokine 2002 Dec, Vol 20 (3) pp 130-135.
Kunicki TJ and Nugent DJ. 2002 The influence of platelet glycoprotein polymorphisms on receptor function and risk for thrombosis. In: Vox Sang. 83, (Suppl. 1):085-090.
Locatelli F, Rocha V, Reed W, Bernaudin F, Ertem M, Grafakos S, Brichard B, Li X, Nagler A, Giorgiani G, Haut PR, Brochstein JA, Nugent DJ, Blatt J, Woodard P, Kurtzberg J, Rubin CM, Miniero R, Lutz P, Raja T, Roberts I, Will AM, Yaniv I. Vermylen C, Tannoia N, Garnier F, Ionescu I, Walters MC, Lubin BH, Gluckman E: Eurocord Transplant Group. Related umbilical cord blood transplantation in patients with thalassemia and sickle cell disease. Blood 2003 Mar 15;101 (6):2137-43
Young G, Manco-Johnson M, Gill JC, DiMichele DM, Tarantino MD, Abshire T, Nugent DJ. Clinical manifestations of the prothrombin G20210A mutation in children: A pediatric coagulation consortium study. Journal of Thrombosis and Hemostasis 2003; May 1:958-962.
Armenian S, Raffel JL, Nugent DJ, Young G. Painless urethral bleeding: An unusual presentation of von Willebrand disease. Haemophilia 2003; 9:332-335.
Chang M, Nakagawa PA, Williams SA, Schwartz MR, Imfeld KL, Buzby JS, Nugent DJ Immune thrombocytopenic purpura (ITP) plasma and purified ITP monoclonal autoantibodies inhibit megakaryocytopoiesis in vitro. Blood 2003 102:(3) 887-895.
Young G, Yonekawa KE, Nagakawa P, Nugent DJ. Argatroban as an alternative to heparin in extracorporeal membrane oxygenation circuits. Perfusion. 2004; 19:283-288.
Schneiderman J, Nugent DJ, Young G. Sequential Therapy with Activated Prothrombin Complex Concentrate and Recombinant Factor VIIa in Patients with Severe Hemophilia and Inhibitors. Haemophilia 2004 Jul; 10 (4): 347-51
Kanaji S, Kanaji T, Jacquelin B, Chang M, Nugent DJ, Komatsu N, Moroi M, Izuhara K, Kunicki TJ Thrombopoietin intitiates demethylation-based transcription of GP6 during megakaryocyte differentiation. Blood. 2005 105, 3888-3892
Flood VH, Johnson FL, Boshkov LK, Thomas GA, Nugent DJ, Bakke AC, Nicholson HS, Tilford D, Brown MP, Godder KT Sustained engraftment post bone marrow transplant despite anti-platelet antibodies in Glanzmann thrombasthenia. Pediatr Blood Cancer. 2005 March 14 PMID: 15768382
McMillan R, Nugent D. The effect of antiplatelet autoantibodies on megakaryocytopoiesis. Int J Hematol. 2005 Feb;81(2):94-9.
Young G, McDaniel M, Nugent DJ. Prophylactic recombinant factor VIIa in haemophilia patients with inhibitors. Haemophilia 2005; 11:203-207.
Rattray B, Nugent DJ, Young G. Rofecoxib as adjunctive therapy for haemophilic arthropathy. Haemophilia 2005; 11:240-244.
Rook JL, Nugent DJ, Young G. Pediatric stroke and methylenetetrahydrofolate reductase polymorphisms: An examination of C677T and A1298C mutations. J Pediatr Hematol/Oncol 2005; 27:590-593
Nugent, DJ Prophylaxis in rare coagulation disorders “ factor XIII deficiency Thrombosis Research. 2006;118 Suppl 1:S23-8.
Tarantino MD, Young G, Bertolone SJ, Kalinyak KA, Shafer FS, Kulkarni R, Weber LC, Davis ML, Lynn H, Nugent DJ, Acute ITP Study Group. Single Dose of Anti-D immune globulin at 75g/kg is as effective as Intravenous Immune Globulin at rapidly raising the platelet count in newly diagnosed immune thrombocytopenic purpura in children. ournal of Pediatrics, 2006 April 489-494
Young G, Blain R, Nakagawa P, Nugent DJ. Individualization of bypassing agent treatment for haemophilic patients with inhibitors utilizing thromboelastography Haemophilia 2006, Nov; 12(6); 598-604.
Nugent DJ. Immune thrombocytopenic purpura of childhood Hematology Am Soc Hematol Educ Program. 2006;:97-103
Young G, Yonekawa K, Nakagawa P, Blain RC, Lovejoy AE, Nugent D, Differential Effects of Direct Thrombin Inhibitors and Antithrombin-Dependent Anticoagulants on the Dynamics of Clot Formation. Blood Coagul Fibrinolysis. 2007 Mar;18(2):97-103
Hoots WK, Nugent DJ. Evidence for the benefits of prophylaxis in the management of hemophilia A.Thromb Haemost. 2006 Oct;96 (4):433-40.
Rattray B, Nugent DJ, Young G. Celecoxib in the treatment of haemophilic synovitis, target joints, and pain in adults and children with haemophilia. Haemophilia. 2006 Sep;12:(5) 14-7.
Lovejoy AE, Reynolds TC, Visich JE, Butine MD, Young G, Belvedere MA, Blain RC, Pederson SM, Ishak LM, Nugent DJ. Safety and pharmacokinetics of recombinant factor XIII-A2 administration in patients with congenital factor XIII deficiency. Blood. Jul 1;108(1):57-62.
Nugent, D. Immune Thrombocytopenia of Childhood. Hematology 2006
Aledort LM, Salama A, Kovaleva L, Robak T, Newland AC, Nugent DJ, Brenner B, Zenker O; International Anti-D Study Group. Efficacy and safety of intravenous anti-D immunoglobulin (Rhophylac) in chronic immune thrombocytopenic purpura. Hematology. Aug;12(4):289-95.
Schneiderman J, Rubin E, Nugent DJ, Young, G Sequential Therapy with Activated Prothrombin Complex Concentrates and Recombinant Factor VIIa in Patients with Severe Hemophilia with Inhibitors: Update of our Previous Experience. Hemophilia (2007),13, 244-248
Cheli Y, Kanaji S, Jacquelin B, Chang M, Nugent DJ, Kunicki TJ Transcriptional and Epigenetic Regulation of the Integrin Collagen Receptor Locus ITGA1-PELO-ITGA2 Biochim Biophys Acta. (2007) 1769:546-548
Young G, Tarantino MD, Wohrley J, Weber LC, Belvedere M, Nugent DJ Pilot dose-finding and safety study of bivalirudin in infants <6 months of age with thrombosis. J Thromb and Haemost 2007; 5: 1654-9.
Young G, Yonekawa KE, Nakagawa PA, Blain RC, Lovejoy AE, Nugent DJ. Recombinant activated factor VII effectively reverses the anticoagulant effects of heparin, enoxaparin, fondaparinux, argatroban, and bivalirudin ex vivo as measured using thromboelastography. Blood Coagulation and Fibrinolysis 2007, 18: 547-553
Manco-Johnson MJ, Abshire TC, Shapiro AD, Riske B, Hacker MR, Kilcoyne R, Ingram JD, Manco-Johnson ML, Funk S, Jacobson L, Valentino LA, Hoots WK, Buchanan GR, DiMichele D, Recht M, Brown D, Leissinger C, Bleak S, Cohen A, Mathew P, Matsunaga A, Medeiros D, Nugent D, Thomas GA, Thompson AA, McRedmond K, Soucie JM, Austin H, Evatt BL Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia. N Engl J Med. 2007 Aug 9;357(6):535-44.
Powell JS, Nugent DJ, Harrison JA, Soni A, Luk A, Stass H, Gorina E. Safety and pharmacokinetics of a recombinant factor VIII with pegylated lipsomes in severe hemophilia A. J Thromb Haemost. 2008 6(2):277-83.
Nugent, DJ., Hsieh, L Factor XIII Deficiency Hemophilia 14(6):1190-2000, 2008.
Nugent, DJ, Simon, D. Platelet Function Defects Hemophilia 14(6):1240-9, 2008.
Kunicki TJ, Williams SA, Harrison P, Segal H, Syed A, Rothwell P, Nugent, DJ . 2009. Lack of association between aspirin responsiveness and six platelet receptor candidate gene haplotypes in patients with symptomatic vascular disease. Thromb Haemost 101:123-133
Kunicki TJ, Williams SA, Salomon DR, Harrison P, Crisler P, Nakagawa P, Mondala TS, Head SR, Nugent DJ. Genetics of platelet reactivity in normal, healthy individuals. J Thromb Haemost 7(12):2116-22, 2009.
Young G, Wicklund B, Neff P, Johnson C, Nugent DJ. Off-label use of rFVIIa in children with excessive bleeding: a consecutive study of 153 off-label uses in 139 children. Pediatr Blood Cancer, 53(2):179-83, 2009.
Kulkarni R, Soucie JM, Lusher J, Presley R, Shapiro A, Gill J, Manco-Johnson M, Koerper M, Mathew P, Abshire T, Dimichele D, Hoots K, Janco R, Nugent D, Geraghty S, Evatt B; Haemophilia Treatment Center Network Investigators. Sites of initial bleeding episodes, mode of delivery and age of diagnosis in babies with haemophilia diagnosed before the age of 2 years: a report from The Centers for Disease Control and Prevention's (CDC) Universal Data Collection (UDC) project. Haemophilia. 2009 15(6):1281-90.
Nugent D, McMillan R, Nichol JL, Slichter SJ. Pathogenesis of chronic immune thrombocytopenia: increased platelet destruction and/or decreased platelet production. Br J Haematol. 2009 146(6):585-96.
Trifiro E, Williams SA, Cheli Y, Furihata K, Pulcinelli FM, Nugent DJ, Kunicki TJ. The low- frequency isoform of platelet glycoprotein VIb attenuates ligand-mediated signal transduction but not receptor expression or ligand binding. Blood. 2009 114(9):1893-9.
Kunicki TJ, Nugent DJ. The genetics of normal platelet reactivity. Blood. (2010) [Epub ahead of print]
Kaveri S, Mannucci PM, Kurth MH, Ewing N, Kessler CM, Nugent DJ, Gomperts ED. von Willebrand factor: what is its role in the immune response in haemophilia Haemophilia 2010 [Epub ahead of print]
Cheli Y, Williams SA, Ballotti R, Nugent DJ, Kunicki TJ. Enhanced binding of poly(ADP- ribose)polymerase-1 and Ku80/70 to the ITGA2 promoter via an extended cytosine- adenosine repeat. PLoS One 5(1):e8743, 2010.
Young G, Zhang R, Miller R, Yassin D, Nugent DJ. Comparison of kaolin and tissue factor activated thromboelastography in haemophilia. Haemophilia 16(3):518-2 (2010).
Lusher J, Pipe SW, Alexander S, Nugent D. Prophylactic therapy with Fibrogammin P is associated with a decreased incidence of bleeding episodes: a retrospective study. Haemophilia. 16(2):316-21, 2010.
Buchbinder D, Nugent D, Vu D, Soni A, Stites J, Hsieh L, Puthenveetil G. Unrelated Hematopoietic Stem Cell Transplantation in a Patient with Congenital Dyserythropoietic Anemia and Iron Overload. Pediatric Transplantation 2010 (In Press)
Cheli Y, Williams SA, Ballotti R, Nugent DJ, Kunicki TJ. PloS One. 2010 Jan 15;5(1):e8743 Enhanced binding of poly(ADP-ribose) polymerase-1 and Ku80/70 to the ITGA2 promoter via an extended cytosine-adenosine repeat.
Kaveri S, Mannucci PM, Kurth MH, Ewing N, Kessler CM, Nugent DJ, Gomperts ED von Willebrand factor: what is its role in the immune response in haemophilia. Haemophilia. 2010 Jun 10. [Epub ahead of print]
Tamary H, Roganovic J, Chitlur M, Nugent DJ. Consensus Paper-ICIS Expert Meeting Basel 2009 treatment milestones in immune thrombocytopenia. Ann Hematol. 2010 Apr 1. [Epub ahead of print]