Allergy and Immunology

In the United States, an Allergist-Immunologist is a physician specially trained to manage and treat asthma and other allergic diseases. Becoming an Allergist-Immunologist requires completion of at least nine years of training. After completing medical school and graduating with a medical degree, a physician will then undergo three years of training in internal medicine (to become an internist) or pediatrics (to be a pediatrician).

Once physicians have finished training in one of these specialties, they must pass the exam of either the American Board of Pediatrics (ABP) or the American Board of Internal Medicine (ABIM). Internists or Pediatricians who wish to focus on the sub-specialty of Allergy-Immunology then complete an additional two years of study, called a Fellowship, in an allergy and immunology training program. Allergist-Immunologist whom are listed as ABAI-certified have successfully passed the certifying examination of the American Board of Allergy and Immunology following their fellowship. They then become Board Certified in Adult and Pediatric Allergy and Immunology.

What is an allergy?

Two people with allergy symptom blowing noseAllergies often heat up in the summer, when allergens such as grass, mold, and ragweed pollen bring on symptoms like wheezing, watery eyes and sneezing. Outdoor picnics and activities can pose more serious dangers for people who are allergic to certain foods or stinging insects. Testing performed by a board certified allergist can diagnose what does and does not trigger your symptoms. Once you know what exactly you are allergic to, you and your doctor will be able to develop a treatment plan to reduce or eliminate your allergy symptoms.

What is allergy skin testing?

Allergy Skin TestingSkin testing, also known as “puncture testing” and “prick testing” is a series of tiny punctures or pricks made into the patient’s skin. Small amounts of suspected allergens and\or their extracts (pollen, dust, molds, food, drugs or venom protein) are introduced to sites on the skin marked with a pen. A small plastic or metal device is used to puncture or prick the skin. Common areas for testing include the inside forearm and the back. If the patient is allergic to the substance, then a visible inflammatory reaction will usually occur within 15-20 minutes. This response will range from slight reddening of the skin to a full-blown hive in more sensitive patients. The skin prick test is the most preferred means of testing because of its simplicity and accuracy. Interpretation of the results of the skin prick test is normally done by allergists on a scale of severity, with +/- meaning borderline reactivity and 4+ being a large reaction.

Should I be tested?

Common Allergic Reactions or Symptoms

Many people with untreated allergy symptoms aren’t aware of how much better they can feel once their symptoms are properly diagnosed and managed. If you are troubled by any of these nagging symptoms, ask your doctor for a referral to an allergist.

  • Itchy eyes, nose, and throat
  • Nasal congestion or runny nose
  • Watery eyes
  • Hives, itchiness or other skin conditions
  • Abdominal pain or diarrhea after eating certain foods
  • Severe reactions to insect stings


What is Intradermal testing?

Intradermal Allergy Skin Test in the Right Upper ArmIntradermal tests are more sensitive than prick tests and may be used when prick tests results are inconclusive. In this test, your allergist will use a syringe to inject the allergen under your skin and monitor for a reaction.

What is patch testing?

Patch Testing
Patch testing is a type of skin testing which helps determine the cause of a patient’s allergic contact dermatitis. This could be a reaction to metals, jewelry, chemicals, medications, rubber compounds, fragrances, and active ingredients found in everyday items. Small disks containing different chemicals are taped to a patient’s back for several days and are then checked for inflammation. Patch testing is different from allergy prick testing because it is looking for delayed skin reactions, and it is not used to diagnose immediate or acute hypersensitivity to food or other allergens.

What is the study of Immunology?

Study of ImmunologyImmunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with, among other things, the physiological functioning of the immune system in states of both health and disease; malfunctions of the immune system in immunological disorders (autoimmune disease, hypersensitivities, immune deficiency).

What is Immunotherapy (Allergy Shot Therapy)?

Allergy Shot TherapyImmunotherapy, once called desensitization, is a treatment in which the patient is gradually vaccinated with progressively larger doses of the allergen in question. This can either reduce the severity or eliminate hypersensitivity altogether. The person begins to build up an immunity to increasing amounts of the allergen in question.

What is Immunodeficiency?

Immunodeficiency conceptImmunodeficiency is the failure of the immune system to protect the body adequately from infection, due to the absence or insufficiency of some component process or substance.

What is IVIG?

IVGIVIG is a blood product administered intravenously. IVIG is a solution of globulins containing antibodies normally present in adult human blood. Globulins are simple proteins that provide immunity against disease. A protein is made up of several amino acids which are the microscopic building blocks that make up all cells. IVIG is used as a temporary treatment to elevate platelet counts. It is used to treat three major categories: immune deficiencies, inflammatory and autoimmune diseases and acute infections.

Administration every month is usually required for treatment of non-HIV Immune Deficiency. Response to treatment is usually seen in 8 days. Immune Globulin comes in sterile solution and is administered intravenously. It is made in different strengths and sizes.

What is Asthma?

Asthma throat imageAsthma is a chronic illness involving the respiratory system in which the airway occasionally constricts, becomes inflamed, and is lined with excessive amounts of mucus, often in response to one or more triggers. These episodes may be triggered by such things as exposure to an environmental stimulant (or allergen), cold, warm or moist air, exercise or exertion, or emotional stress. In children, the most common triggers are viral illness such as those that cause the common cold. This airway narrowing causes symptoms such as shortness of breath, coughing and wheezing.

Between episodes, most patients feel well but can have mild symptoms and they may remain short of breath after exercise for longer periods of time than the unaffected individual. The symptoms of asthma, which can range from mild to life-threatening, can usually, be controlled by a combination of drugs and environmental changes. Public attention in the developed world has recently focused on asthma because of its rapidly increasing prevalence, affecting up to one in four urban children. Symptomatic control of episodes of wheezing and shortness of breath is generally achieved with fast-acting bronchodilators. These are typically provided in pocket-sized, metered-dose inhalers.

What is Challenge Testing?

Allergenic food isolated on whiteChallenge tests are sometimes used when a doctor suspects you have a food or drug allergy. In this test, patients eat or inhale a very small amount of possible allergens under the close supervision of an allergist. Do not do this at home!

What are Allergy Blood tests?

Hand of a doctor holding a bottle of blood sampleFor this test, blood is drawn and then tested for allergies. This test costs more than some other tests. It will also take longer to receive your results.

What is Anaphylaxis?

Epinephrine injector for treating severe allergic reactions

Anaphylaxis is a serious allergic reaction that typically comes on quickly and may cause death if not treated. This medical emergency requires immediate treatment and then follow-up care by an allergist/immunologist.  This treatment usually requires an injection of epinephrine and a trip to a hospital emergency room. Anaphylaxis is triggered when the immune system overreacts to a usually harmless substance such as (an allergen such as peanut or penicillin) causing mild to severe symptoms that affect various parts of the body. Symptoms usually appear within minutes to a few hours after eating food, swallowing medication or being stung by an insect.



Symptoms of anaphylaxis may include:

  • Wheezing, shortness of breath, throat tightness, cough, hoarse voice, chest pain, trouble swallowing, itchy mouth
  • Low pulse, dizziness, low blood pressure
  • Hives swelling, itch, rash,
  • Nausea, diarrhea
  • Vomiting, anxiety, headache