Specialised services

Skin Prick Testing

Skin prick testing is the gold standard of identifying allergen sensitisation. This is done on healthy skin of patients. We test babies from three months of age. It is not a painful procedure and staff is well trained. Results are available in 20 minutes. Antihistamines need to be stopped a week prior to the testing. A cost-effective procedure.

Lung Function Tests

Spirometry is done to diagnose asthma. A test is done before and after using a short acting ß-agonist inhaler. The reversibility factor will determine if asthma is present or not or in and asthmatic already on treatment, controlled or not. The test can be done successfully from the age of seven/eight years.

Immunotherapy

This is the desensitisation process of giving allergens that is causing symptoms in incremental doses to induce tolerance in the immune response. It can be done via subcutaneous injections or oral drops. It is done for at least a three period. Bee venom, grass, house dust mite, horse and moulds are the most common allergens used.

our services

Our list of conditions we manage

Adverse drug reactions

These reactions to medication include a huge rage of reactions including, but not solely, drug allergies. Allergic reactions can be IgE mediated but can also include Non-IgE -mediated immune responses. A detailed medication history is of utmost importance to be able to determine which drug was the one leading to the allergic reaction. Non-steroidal anti-inflammatory drugs and antibiotic is the most common cause of allergic reactions.

Asthma

Chronic inflammatory condition of the lower airways leading to hyperresponsive airways with a tight chest due to reversable bronchoconstriction. Not all asthmatics are allergic but early onset, in childhood, usually are. These asthmatics will often also have AR, as we have learned from the united airways concept. Asthma is treated with reliever inhaler during an exacerbation and with a controller, the anti-inflammatory drug, used daily.

Allergic Rhinitis (AR)

Chronic inflammation of the nasal mucosa. This leads to an itchy nose, watery discharge, sneezing and often a blocked nose. Patient might have eye symptoms as well. Itching of the throat and palate can lead to constant clearing of the throat. A blocked nose can lead to mouth breathing with abnormal development of the palate, dry lips, and poor quality of sleep. AR can be intermittent or persistent and the treatment will be according to the classification.

Environmental Allergies

This group of allergies would include allergic skin reactions to chemicals such as household cleaning products of contact to plants while gardening. Chemical products can also lead to respiratory allergies or conjunctivitis. Air fresheners or the use of insect repellents can be a trigger of allergic reactions. Air pollution like field fires and weather changes can lead to exacerbations of AR and asthma. The use of hand sanitizers can lead to skin allergies.

Anaphylaxis

Anaphylaxis is the most extreme form of an allergic reaction and is a life-threatening condition. The most common triggers are food allergens, bee venom allergy and medications (Drugs). Of food allergies, nuts, peanuts, and seafood are the most common triggers but any food can trigger a severe reaction in a specific patient. The treatment of anaphylaxis is intramuscular adrenalin. Antihistamine or steroids will not stop this reaction.

Allergic conjunctivitis

Allergic inflammation of the conjunctiva of the eyes. This condition again can be intermittent or persistent. Often co-exists with AR. The eyes are extremely sensitive, itchy, watery, and dry. Regular eye rubbing may, over time, lead to complications such as keratoconus. Using a natural tear drop and an oral antihistamine might not be enough to alleviate symptoms and protect the eye. Treatment of the AR with an intranasal steroid often improve eye symptoms.

Bee venom allergy

An allergic reaction to the honeybee can be mild, causing a local reaction around the area of the sting, but it can also lead to a systemic or anaphylactic reaction. A systemic reaction will be diagnosed if the reaction spreads beyond local swelling of the limb for instance. It is important to confirm the diagnosis. This is done on a blood test. In cases of systemic involvement or an episode of anaphylaxis, specific immunotherapy is indicated.

Atopic Eczema

Chronic inflammation of the skin leading to dry, itchy patches. This is often present in babies as the first presentation of sensitization to allergens. In babies often in the face and neck but can include body and limbs. In older kids and adults usually in the flexure areas of the limbs. Daily use of a good quality emollient is of essence. Antihistamines can elevate the itch but will not treat the condition. Quality off life poor if untreated.

Hereditary Angio-edema (HA)

This form of angio-edema has a familial tendency. It involves swelling of the subcutaneous and submucosal layers and can involve mostly the skin, respiratory tract and the gastrointestinal tract. It is a painful condition. HA does not respond to antihistamines or steroid treatment. This condition is due to a lack the C1-esterase inhibitor protein or dysfunctional C1-INH. Trauma might often be a trigger and abdominal involvement present in 90% of patients.

Occupational Allergies

This is an area of great concern as it can lead to the fear of loss of income. Both the patient and the employee can be guided in the process of diagnosis and action plans. Occupational asthma, for instance can be due to a work-related trigger causing asthma for the first time in life, but it might just be aggravating existing asthma. Latex allergy in the medical field can lead to contact dermatitis of hands but can lead to asthma and worse case to anaphylaxis.

Urticaria / Angio-edema

Itchy hives is a troublesome condition of the skin and if the deeper layers are involved, swelling can be painful angio-edema. Acute urticaria lasts up to six weeks. A specific lesion or hive will be in one area for minutes up to 24 hours. It typically comes and goes and enlarge when scratched. If it is present for most days for a period longer than 6 weeks, it is chronic urticaria. This is not always due to an allergic reaction.

Food Allergies

A food allergy can be due to an immediate IgE reaction or it can be due to a non-IgE immune response. The incidence of food allergies is currently on the increase in the world. This might be due to several reasons including the overuse of anti-biotics. Testing of food allergens can be misleading if not interpreted correctly due to cross reaction between allergens. A detailed food history is, and symptom dairy is of great importance to diagnose correctly.