Clinical Immunology and Allergy Service

Patients are referred by another hospital specialist or GP.

Our guidelines for doctors referring patients to our clinic are available below:

• Referral guidelines for general allergy clinic
• Referral form for the anaesthetic allergy clinic.

We look carefully at referrals before judging whether to arrange an outpatient appointment. 

Sometimes, we are unable to offer an appointment. This can be because:

• We haven’t been given enough information in the referral
• The referral is for a problem/condition that we don’t feel we can help with
• We feel that some investigation, treatment, or other strategy can be tried before considering whether the patient needs to see us in the clinic.

If we don’t offer an appointment, we always advise the referring doctor of the reason for this.

If we do offer an appointment, the details will be sent to you.

• PIDUK
• BSACI
• Anaphylaxis UK
• Allergy UK   
• Immunodeficiency UK

Outpatient clinics are held weekly at Broadgreen Hospital. Immunotherapy and challenges are also held at Broadgreen as well as an Immunology clinic that operates every Tuesday. 

Please note that new clinics are undertaking face-to-face appointments unless there are exceptional circumstances. Follow-up clinics are a mix of face-to-face and virtual.

Immunoglobulin infusion day cases are run each Wednesday by nurses on Ward 10. The nurses run a training programme for self-administration of immunoglobulin and C1-inhibitor for those willing to go on home therapy, to allow them to lead a more normal life. The training is carried out at Broadgreen and regular technique reviews can be undertaken either virtually or face-to-face. There is also an option to have immunoglobulin infusions administered by a private homecare nurse. 

The service also provides clinical assessment, investigation and holistic management for adults with suspected and established immunodeficiency (Primary and Secondary, excluding HIV) including:

• Antibody deficiency
• Hereditary angioedema (HAE)
• Combined immune deficiency
• Neutrophil defects
• Complement deficiency
• Other primary immune deficiencies
• Secondary immune deficiencies.

Primary Immunodeficiency (PI) causes children and adults to have infections that come back frequently or are unusually hard to cure. If you are affected by two or more of the following warning signs, speak to your doctor about the possible presence of an underlying PI:

• Four or more new ear infections within one year
• Two or more serious sinus infections within one year
• Two or more months on antibiotics with little effect 
• Two or more pneumonias within one year
• Failure of an infant to gain weight or grow normally
• Recurrent, deep skin or organ abscesses
• Persistent thrush in mouth or fungal infection on skin
• Need for intravenous antibiotics to clear infections
• Two or more deep-seated infections including septicaemia
• A family history of PI.

After your appointment you will receive a copy of the letter addressed to your GP and any other specialists involved in your care. Letters addressed to your GP or other specialists may contain diagnosis/ probable diagnosis, management plan, information about any investigations either done or planned and information on what happens next. 

The Allergy Service provides facilities for the investigations, diagnosis and management of allergic diseases including:

• Food allergy
• Anaphylaxis
• Antibiotics and other drug allergies 
• Anaesthetics allergy
• Venom allergy
• Allergic rhinitis 
• Urticaria and angioedema 
• Latex allergy
• Allergen specific immunotherapy (desensitisation), including venom, grass and tree pollens and house dust mites
• Oral challenge test to food and drugs
• Aspirin and other drug desensitisation.

During clinic appointments we may need to test you for allergy with either skin tests, blood tests or both. In some cases, no testing is required. 

If a food is suspected as a possible cause of your allergic symptoms, please have the main ingredients or a list of ingredients which are of concern. In particular, testing for fruit and vegetables is best done with fresh, raw ingredients so it is very useful if you can bring these with you for face to face appointments e.g. apple, banana, carrot. If the possible allergen is a drug, please have the actual box of the drug or the name of the drug.

Skin Prick Tests (SPT) involve placing some of the items being tested on your forearm, pricking through the skin and assessing the response 15 minutes later. SPT is considered to very safe and the risk of a severe reaction is very low. Some patients’ experience an itch at the site of one or more of the pricks however this settles within half an hour. Further skin testing called an Intradermal Test (IDT) may be required where a substance will be injected into the top layers of the skin and the response checked after 20 minutes. Depending on the results blood test may also be recommended. 

It may also be necessary to undertake an allergy challenge to establish if or how you react to a food or medication. 

Allergen Immunotherapy (Desensitisation) is provided for lots of allergens including pollens, dust mites, venom and in exceptional circumstances animal allergies.
Immunotherapy is a course of injections given at certain intervals, for a total course of three to five years. The number of injections depends on the type of allergen.

Please note that the department does not offer services to patients with:

• Chronic fatigue syndrome
• Food intolerance
• Irritable bowel syndrome (IBS)
• Eczema
• Chemical (hair dye, cosmetics) sensitivities
• Mast cell activation disorder.