An allergist-immunology specialist is a physician who has had years of comprehensive training in the field of allergy and immunology. An allergist-immunologist has been trained in either internal medicine or pediatrics and completes an additional 2 or more years of sub-specialty fellowship training in allergy and immunology in an accredited training program. After completing allergy-immunology fellowship training, and in addition to being board certified in Internal Medicine or Pediatrics, they need to take the board certification examination given by the American Board of Allergy and Immunology.
The allergist can help if you think you have the following conditions:
Allergic rhinitis is a prevalent problem with one in five people suffering from the disease. For many it can be bothersome especially during flare-ups. This condition is caused by an allergic reaction that occurs in the nose and eyes after an allergen sticks on the nasal or ocular membranes. Aeroallergens, such as pollens, mold spores, and fine particulate matter that get airborne, from insect excretions, such as dust mites, cockroaches, or animal secretions from cats and dogs, can get deposited in our eyes, or can be inhaled causing symptoms of allergic rhinitis and allergic conjunctivitis. Symptoms of allergic rhinitis include sneezing, runny nose, itchy nose, and nasal blockage.
Allergic conjunctivitis is usually part of the symptom complex that is seen in patients with hay fever however, there are some individuals who suffer from eye symptoms only. This is usually caused by the same air-borne allergens (aeroallergens) that cause allergic rhinitis. The symptoms are usually intense with acute (short term) exposure as seen in seasonal spring pollen allergies, or with cat allergies. Patients who have allergic conjunctivitis experience sudden onset of intense itching and watering of the eyes, with some redness and swelling of the eyelids.
Asthma is a chronic lung condition that results from inflammation and narrowing of the airways causing symptoms of coughing, wheezing (a whistling sound), shortness of breath and chest tightness. The bronchial tubes or airways are the passage ways for air to get into our lungs. It is when these tubes or passages get inflamed from aeroallergens or other irritants that asthma symptoms develop. The narrowing of the airways is caused by a combination of bodily reactions including constriction of the airway muscles, swelling of the bronchial airways, and plugging from thick mucus secretions. Asthma attacks are usually bothersome and disabling and can even be fatal if left untreated. Anyone who has symptoms of shortness of breath, cough, wheezing and chest tightness should seek medical attention from an allergist or asthma specialist so they can be evaluated and treated for asthma.
Anaphylaxis(systemic allergic reactions)
Anaphylaxis is an allergic reaction that occurs very rapidly and may result in death if not identified and treated right away. This potentially life-threatening condition occurs when the immune system over reacts to an allergen such when ingested in food or drug allergies, or injected such as in insect stings and injectable medications. The symptoms occur within minutes to several hours after the allergenic substance is ingested or injected into the body. It can be mild however caution must be really made since it can be fatal. The symptoms could include shortness of breath, chest tightness, wheezing, dizziness, itching, swelling, hives, flushing, redness, throat tightness, difficulty swallowing, nausea, vomiting, lightheadedness, low pulse, pale/blue color, low blood pressure, shock and death. It is extremely important that medical attention be sought immediately, and follow-up be made with an allergist to evaluate and manage this serious allergic condition. Anyone who has had an anaphylactic reaction should always have an epinephrine or adrenaline autoinjector for emergency use, and be familiar with its use.
Food allergy or anaphylaxis
Food allergies occur when an individual with allergic tendencies becomes sensitized to certain food proteins. Eggs, milk, soy, wheat, shellfish, peanuts and nuts are foods that commonly cause food allergies. Anaphylaxis (create link to anaphylaxis above) should not be taken likely since they can be potentially fatal. Avoidance should be strictly enforced. Your allergist can perform allergy skin testing to determine if you have food allergies.
Insect venom allergy or anaphylaxis
Allergic reactions to insect stings occur in about 3% of the general population and can be fatal even with the first sting. Localized reactions are more common and rarely serious however, most people have the perception that when they have a large localized reaction to an insect sting, think that they are “allergic” to the sting. Venom skin testing and RAST blood testing can help accurately determine whether one is allergic to insect venom stings. Insect venom immunotherapy (allergy injections) is effective in 75-98% in preventing anaphylaxis from repeated insect stings. See an allergist who can formulate an allergy injection regimen if it is determined that you have insect venom anaphylaxis.
Coughing is a defense mechanism that our body uses to clear particles or substances in our throat and airways. Sometimes a cough can become chronic which can become annoying and embarrassing, and can wear one down physically especially when it impairs one’s sleep. Chronic cough can be caused by several medical conditions including post-nasal drip, asthma, and gastro-esophageal reflux disease. Other medical conditions that can cause a chronic cough include chronic lung diseases such as COPD seen in long-term smokers, chronic infections and some medications. A full evaluation by an allergist should help determine whether the cause of your chronic cough is from allergies or not.
Dermatitis is a generalized term used to describe skin inflammation. There are several kinds and causes of skin inflammation which can affect different parts of the body. The skin usually appears red, swollen and itching, and sometimes can have weeping, blisters or sloughing of the skin. There are allergic and non-allergic causes of skin inflammation. Typical allergy-related dermatitis include atopic dermatitis (also called eczema) and contact dermatitis which usually results from an allergic reaction in the skin. Allergists can help tell whether you have eczema, contact dermatitis or not, and recommend a treatment plan for you.
Hives occur when the mast cells and basophils in the skin release a tremendous amount of histamine causing an intensely itchy rash that looks reddish, smoothly raised areas over the skin, with varying sizes and sometimes merging and coalescing with each other. Hives spontaneously resolve without leaving any residual marks on the skin. Hives bother 20 percent of the general population at some time in their lives. Hives are classified as acute urticaria (less than 6 weeks) or chronic urticaria (lasting more that 6 weeks). Most people mistakenly think that hives are caused by allergies however non-allergenic causes attribute for the majority of hives. Hives can be caused by viral infections or medications, but in most cases, they are “idiopathic” meaning of unknown cause. Seeing an allergist can help you determine if your hives are due to allergies or not.
While hives are due to swelling in the skin, angioedema is due to swelling of areas just under the skin. This results in swelling of various parts of the body as seen in the face, eyes and lips. Angioedema can also occur in the hands, feet, and even in parts of our oral and respiratory tract such as seen in tongue and throat swelling. Angioedema is a symptom seen in allergic reactions such as with food, drug or insect venom allergies, or seen in association with urticaria (hives/welts), or in association with some rare medical conditions such as lymphoma, connective tissue diseases, or complement system deficiency.
Occupational Allergic Diseases
Allergies in the workplace are a significant source of illness. Workers are exposed to a multitude to chemicals, particles and allergens however the diagnosis can often be suspected because of the patient’s clinical history. Occupational allergies depend a lot on how the allergen is introduced thus workers can develop allergic rhinitis, allergic conjunctivitis, asthma, and cutaneous allergies. Some chemicals at work can also cause sensitization resulting in unique allergic reactions seen only in the work setting. Allergists, pulmonologists, dermatologists and occupational medicine specialists are doctors who have the unique training required to evaluate and treat patients with work-related allergies.
Sinusitis occurs when the lining of the sinuses get inflamed. The sinuses are air pockets or spaces located in the skull around the nose and eyes, and are lined with similar membranes that line the nasal membranes, and drain into the nasal cavity. When the sinuses cannot drain due to inflammation or infection and get filled with mucus or secretions sinusitis develops. Various conditions can cause sinusitis including the common cold or allergies, and other conditions that can cause anatomical blockage of the sinus drainage system. Allergists are trained to evaluate and medically treat sinusitis.
Drug allergies or drug hypersensitivities can range from being mild and annoying to being serious and even life-threatening. However not all reactions to drugs are a result of allergies and it is important to distinguish a drug sensitivity from a true drug allergy. An allergy specialist will be able to distinguish the intricate differences between an allergic and non-allergic drug reaction.
True drug allergies such as penicillin allergies can range in severity. These symptoms can include hives, itching, facial swelling, throat swelling, shortness of breath, wheezing, abdominal cramps, nausea, and/or vomiting, and should be taken very seriously. Some allergic reactions can rapidly evolve into a serious, life-threatening reaction and result in death. An allergist should be consulted when we become suspicious of having a drug allergy.
Drug hypersensitivities can appear like true drug allergies. An example would be the hypersensitivity to aspirin or IV contrast dye. The symptoms seen with these drug reactions appear very similar to drug allergies however are not true immunologically-caused allergic reactions. Sometimes patients can still take aspirin or IV contrast dye if given correctly or with the correct preventive concoction of medications. Thus it is important, if you are unsure of your type of drug adverse reaction, an allergist should be consulted so that you are not deprived of drugs that may be beneficial.
Primary Immune Deficiencies
Primary immunodeficiencies are not allergic conditions however most allergists have the training and qualifications to treat immunologic problems or deficiencies. The most common immunodeficiency treated by allergist/immunologists are “humoral antibody deficiencies” which is when a patient’s immune system develops the inability to produce antibodies to fight off infections. Patients with immunodeficiencies typically have recurrent infections such as sinusitis, pneumonia, or bronchitis which tend to recur after coming off antibiotics. An allergist/immunologist can perform an immunologic work-up to determine if one has a humoral immunedeficiency, and formulate a treatment plan such as antibody or immunoglobulin replacement therapy to prevent further recurrent infections.