Lauren Henderson ¹ Roshini Sarah Abraham ² Aisha Ahmed ³ Lindsey Swigart ³ Scott W Canna ^4,5 Natalia S Chaimowitz ⁶ Shanmuganathan Chandrakasan ^7,8 Bria Coates ⁹ James A Connelly ¹⁰ Megan Anne Cooper ¹¹ Christine Noel Duncan ^12,13 Anthony French ¹¹ Melissa Hazen ¹⁴ Michelle Hermiston ¹⁵ Brian Nolan ⁹ Anish Ray ^16,6 Melissa J Rose ^17,2 Lisa Renee Forbes ^18,19 Grant Schulert ^20,21 Sara Kristen Sexson Tejtel ^22,23 Tiphanie Phillips Vogel ^19,24 Kelly Walkovich ^25,26 Matt S Zinter ²⁷ Edward Behrens ^28*

• ¹ Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
• ² Nationwide Children's Hospital, Columbus, Ohio, United States
• ³ Division of Allergy and Immunology, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital, Chicago, Illinois, United States
• ⁴ Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
• ⁵ Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
• ⁶ Cook Children's Medical Center, Fort Worth, Texas, United States
• ⁷ Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, Colorado, United States
• ⁸ School of Medicine, Emory University, Atlanta, Georgia, United States
• ⁹ Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
• ¹⁰ Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
• ¹¹ Division of Pediatric Rheumatology, Department of Pediatrics, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
• ¹² Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, United States
• ¹³ Departments of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States
• ¹⁴ Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts, United States
• ¹⁵ Benioff Children's Hospital, University of California, San Francisco, San Francisco, California, United States
• ¹⁶ College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, United States
• ¹⁷ Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
• ¹⁸ Division of Pediatric Immunology, Allergy and Retrovirology, Department of Pediatrics, Baylor College of Medicine, Houston, Ohio, United States
• ¹⁹ Center for Immunobiology, Texas Children's Hospital, Houston, Texas, United States
• ²⁰ Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
• ²¹ Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States
• ²² Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States
• ²³ Texas Children's Hospital, Houston, Texas, United States
• ²⁴ Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States
• ²⁵ C. S. Mott Children's Hospital, Ann Arbor, Michigan, United States
• ²⁶ Division of Pediatric Hematology-Oncology, Department of Pediatrics, School of Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, United States
• ²⁷ Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, California, United States
• ²⁸ Children's Hospital of Philadelphia, Philadelphia, United States

Patients with immune dysregulation may present with varying combinations of autoimmunity, autoinflammation, immunodeficiency, atopy, lymphoproliferation, and/or malignancy, often with multisystem involvement. Recognizing specific patterns of immune dysregulation, coordinating and interpreting complex diagnostic testing, and choosing initial (often empiric) treatment can be challenging. Centers are increasingly assembling multidisciplinary teams (MDTs) to standardize evaluation and optimize treatment of patients with complex immune dysregulation (immune dysregulation MDTs [immMDTs]). However, published information on the composition and function of immMDTs is sparse, and there is little guidance for those seeking to establish or optimize an immMDT. To inform this review, we assembled a panel of 24 pediatric providers from multiple specialties who actively participate in immMDTs to provide expert opinion. We also conducted a search of the available information on pediatric immMDTs from PubMed. Based on these insights, we summarize the structure and function of active immMDTs across the United States and focus on best practices and context-dependent solutions that may enable institutions with varying goals, patient populations, and resources to establish an immMDT.