1.  ALLERGIES: where there is an excessive immune response to an external or environmental substance such as foods, drugs, pollens, mould spores, animal fur, house mites, latex etc.   Some allergies are very common and some are very rare.  Sometimes an illness may look like an allergy but actually be due to a non-allergic mechanism.   These mechanisms may include chemical and drug effects and emotional factors.  Many allergic disorders are the result of multiple factors.  Disorders routinely seen include ANAPHYLAXIS, URTICARIA AND ANGIOEDEMA, ATOPIC ECZEMA, INSECT STING ALLERGY, ASTHMA, EYE AND NOSE ALLERGIES (RHINO-CONJUNCTIVITIS/HAYFEVER), FOOD ALLERGY AND PSEUDO-FOOD ALLERGY, DRUG ALLERGY AND HYPERSENSITIVITY (INCLUDING ASPIRIN AND PENICILLIN), EXCESSIVE REACTIONS TO PERFUMES AND ODOURS ETC.

2. IMMUNE DEFICIENCY: where the immune system fails to react as well as it should and the person becomes prone to infections of different kinds depending upon what aspect of the immune system is deficient.  Immune deficiency may be present at birth or develop later in life.  Disorders routinely seen include ANY PATIENT WITH A TENDENCY TO RECURRENT OR UNUSUAL INFECTIONS.

3.  AUTO-IMMUNE DISEASES: where the immune system reacts against the tissues of the body rather than confining itself to foreign invaders and threats.  Disorders routinely seen include VASCULITIS, VASCULITIC URTICARIA, SUSPECTED CONNECTIVE TISSUE DISORDERS, AUTOIMMUNE DISORDERS.

4.  MISCELLANEOUS: the Department is frequently asked to help decide whether or not a patient's illness is due to an immune disturbance.  Sometimes this is because the patient has symptoms involving many body systems or organs.  The immune system is by its very nature involved with all bodily systems, and disturbances of the immune system commonly cause multisystem disorders.  There are other disorders where questions about the immune system may emerge such as CHRONIC FATIGUE, POST-VIRAL SYNDROME, CHEMICAL SENSITIVITY, GLUTEN SENSITIVITY, MULTIPLE DRUG HYPERSENSITIVITY, PSEUDO-FOOD ALLERGY, PSYCHOSOMATIC OR 'MINDBODY' DISORDERS.

The Immunology Laboratory does a wide range of specialised tests for all these immune disorder categories. 

Immunology Outpatient Clinic
If your GP wants advice about the diagnosis or management of an immunological or allergic illness, they may refer you to this clinic.  Your referral is given priority depending on the information in the referral letter.  It is important that, if your condition worsens while waiting to be seen, you revisit your GP because we can provide more urgent consultation.  Our average waiting time for a routine outpatient appointment is 3-4 months. More urgent patients may expect a wait of 1-2 months.  

At the clinic you will be seen by a Consultant Immunologist or an Immunology Registrar (who will discuss your case with the consultant). The doctor will take a detailed history of your symptoms and ask about previous illnesses and what medications you are on.  The history is the crucial part of the consultation.  Part of good history-taking includes asking questions about what you do for a living, who you live with, what support you have, and mood and emotional factors.  You will also be asked about smoking, alcohol etc.  There will be other questions about your health designed to add helpful information to diagnose what is causing your symptoms.  The doctor will then examine you.  They will explain to you as they go the reasons for the examination and then what tests or treatments are coming.

If relevant, the doctor may ask for skin tests to be performed, either on the first clinic appointment or at a subsequent appointment.  Certain skin tests may take some time to perform (up to 2 hours).

You may be started on some medications or asked to undergo further testing (e.g. blood tests) before being seen again in the clinic or may be referred back to your GP for ongoing management. A letter will be sent to your GP (and commonly copied to you) with treatment recommendations as well as the results of any tests that are undertaken.

Some patients will be referred to the Immunology Day Ward for further investigations or management.  These would include patients who need drug, venom or inhalant allergen immunotherapy (desensitisation) and also patients who need challenge procedures (e.g. with drugs or foods).  Our waiting time for Day Ward interventions varies but may be up to 3-4 months.