Our mission is to relieve suffering caused by asthma and other allergic diseases and to improve quality of life through knowledge, dedication, research, and compassion.
Our mission is to relieve suffering caused by asthma and other allergic diseases and to improve quality of life through knowledge, dedication, research, and compassion.
What is Asthma?
Asthma is a disease that causes narrowing of the airways in your lungs. During an “asthma attack”, you may feel short of breath, wheeze, and cough or have tightness in your chest. In between asthma attacks, the disease is still there – even when you have no symptoms. Many children seem to “outgrow” their asthma, but teenagers and adults may have asthma for the rest of their lives.
What happens during an asthma attack?
If you have asthma, your airways are “twitchy”. They are very irritable and sensitive to certain “triggers” – things you may be allergic or sensitive to, such as pets, house dust, pollen, viral infections, cold air or exercise.
How is asthma diagnosed?
The diagnosis is a clinical one using a combination of the patient’s symptoms, physical findings, and response to medications. Often times skin testing and spirometry, a special kind of breathing test that measures your lung volumes are performed.
Allergic conjunctivitis or “Eye Allergy”
Eye allergy occurs when the delicate lining of the eye, or conjunctiva, becomes irritated by an allergen. Symptoms of eye allergy can include itching, redness, burning, clear watery discharge, and swelling. While eye allergy is not contagious, it can be confused with a viral or bacterial infection of the eye such as pinkeye. Eye allergy can occur alone but are usually accompanied by the symptoms of hay fever which are nasal drainage, congestion and sneezing.
Eye Allergy Symptoms:
Eye Allergy Management and Treatment:
Medications for eye allergy:
An allergist can prescribe additional medications which are very effective against eye allergy:
What is allergic rhinitis?
Allergic rhinitis, also referred to as “hay fever” affects as many as 40 million Americans which is roughly one out of every six individuals. This disease is more common in the pediatric population. The average allergic rhinitis patient is symptomatic for five months in a year.
Allergic rhinitis is an inflammatory disease. This inflammation results in a swollen nasal lining that produces fluid and mucus. This inflamed tissue is also hyper-reactive to a variety of stimuli.
What are the symptoms of allergic rhinitis?
How is it treated?
What is sinusitis?
Sinusitis (infection of the sinuses) is very common. Some studies suggest that 15-20% of the population are affected by chronic sinusitis at some time in their lives. There are 4 paranasal sinuses. These are the maxillary, ethmoid, sphenoid, and frontal sinuses. Only the ethmoid and maxillary sinuses are present at birth. The sphenoid sinus develops sometime after age 2 years and the frontal sinuses begin to develop by age 6 years.
What are the symptoms of sinusitis and how do we diagnose it?
Clear or thick nasal drainage and cough are the major symptoms of sinusitis. Other symptoms include fever, headache, facial pain, earache, nasal congestion, tooth pain, inability to smell, sore throat, foul breath, irritability, eye swelling, cough and worsening of asthma. The most common factors that predispose an individual to sinusitis are viral upper respiratory tract infections (“colds”, allergic rhinitis, nasal polyps, anatomical abnormalities, and defects of the immune system).
Complications that may arise from sinusitis include worsening of asthma, ear infection, and rarely extension of the infection to the bones of the head and the brain. Occasionally, an x-ray or CT scan of the sinuses must be obtained to thoroughly examine the anatomy of the sinuses.
How do we treat sinusitis?
Treatment is aimed at killing the bacteria found in the sinuses with antibiotic, promoting adequate drainage of the sinuses and eliminating the inflammation and swelling found in the sinuses. For patients who suffer from recurrent sinusitis, measure directed at the prevention of recurrent attacks are the most important principles in the management of sinus disease.
– Kill the bacteria: Amoxillcin or a similar antibiotic is the drug of choice for sinusitis. However, if there is not a response to treatment within a few days or if there is evidence of recurrent or chronic disease, other antibiotics may need to be used. Antibiotic therapy is continued for 14 days and may need to be extended to 30-45 days on some episodes.
– Drainage of the sinuses: as with any infection, the bacteria and pus must have an opening to drain. Oral decongestant help shrink swollen tissue and thus can assist with drainage. Topical decongestants also help shrink swollen nasal tissue, however, they cannot be used form more than three days as a dependence quickly develops with continued use. Topic nasal steroids will help reduce the inflammation and swelling present in sinusitis and thus will also assist in drainage. Their ability to decrease inflammation is not seen until several days after starting these agents. Irrigation of the most can remove secretions and liquefy mucus. Irrigation can be performed with steam, hot showers, vaporizers, a saline sprays. Sometimes surgery may be required to correct an anatomical abnormality that may be responsible for inadequate drainage. Most sinus surgeries can be performed using a limited endoscopic approach with a very high success rate.
– Prevention: preventive measure include treatment of allergic rhinitis with nasal steroids, avoidance of allergens and viruses, and if indicated, immunotherapy.
What is Insect allergy?
Members of the Hymenoptera family of flying insects include honey bees, wasps, hornets, and yellow jackets. Individuals who have developed an anaphylactic reaction to these insect’s venom are at high risk of developing another anaphylactic reaction when re-stung. Approximately 50% of individuals allergic to these venoms are at risk of developing a severe reaction when re-stung.
What are the symptoms of Insect allergy?
How do we treat insect allergy?
Obtaining appropriate treatment if anaphylaxis develops after a sting can save your life. Immediately after being stung, perform the following:
Immunotherapy (shots for insect stings) will lower your risk of developing anaphylaxis following a sting. It will bring your risk to that of the general population (about 1-3%), and if you do develop anaphylaxis following a sting, immunotherapy will lessen the severity of the reaction.
A food allergy is when a person has a reaction after eating a food. Specifically, an allergy antibody binds special cells and causes release of chemicals that cause symptoms of hives, swelling, itching, redness, shortness of breath, nausea, vomiting, diarrhea, dizziness, and even death. Most reactions occur within minutes to an hour or two after ingestion of the food. People can also have reactions after touching or inhaling the cooking vapors of certain foods.
The most common foods implicated in food allergy are “the big eight”
Food allergies usually appear in childhood and some, such as milk and egg allergy, are likely to be outgrown. Others, like peanut and shellfish, persist into adulthood. People can have an allergy to one or more foods.
Symptoms can differ from person to person. Also, a person can have different symptoms each time he or she has an allergic reaction.
Food allergy management:
Your doctor may perform allergy testing via skin testing or bloodwork. In some cases, both types of testing are appropriate. If any of the testing is positive or if the history is consistent with a food allergy it is very important to strictly avoid that specific food. Ingestion may cause severe symptoms or possibly death even if an earlier reaction was mild. Sometimes it can be difficult to know what food is causing symptoms. In these cases keeping a food diary is helpful. Reading labels is very important since one type of food may have many different names after being processed. Some patients wear a medical alert bracelet to let others know to what foods they are allergic if they should lose consciousness.
If a food has been accidentally eaten, the best treatment is a medicine called “epinephrine.” All food-allergic patients should carry epinephrine autoinjectors with them at all times. 911 should be called immediately – at the hospital, doctors can give you epinephrine and other medicines to treat your symptoms. Doctors will also watch to make sure your symptoms don’t get worse. Antihistamines are also used to help with symptoms of itching and hives.
Is there any way to prevent a food allergy? — It’s not clear. If you have a food allergy — or your child does — other family members may have a higher risk of the same allergy. For pregnant or breastfeeding women it is not safe to avoid a food necessary for basic nutrition, such as milk, prior to talking with your doctor. When your baby is old enough to start eating solids, you will have to decide when to offer the food. Doctors used to think it was better to delay this if a baby was at high risk for allergy. Now, they think it might be better not to wait until the baby is older, and to give the food at the normal time. But there is still no way to know for sure if your baby will have an allergy. Your baby’s doctor can help you decide when and how to offer certain foods.
What is a drug allergy?
A drug allergy is a bad reaction to a drug that happens when the body’s immune system responds to a drug as if it were a dangerous invader and tries to fight it off. Normally the body’s immune system should not react to a drug as though it were an invader, but some drugs can cause that response in some people.
A drug allergy is NOT the same as a drug side effect. Side effects are unintended or unwanted effects that drugs can cause.
What are symptoms of a drug allergy? – There are different types of drug allergies with their own set of symptoms.
“Immediate” allergy – it starts quickly after a drug is taken (usually within an hour or so). This type of allergy is serious because it can get worse if the medicine is continued. It can turn into a life-threatening whole-body allergic reaction, called anaphylaxis. Symptoms include:
Another type of drug allergy, called a “delayed” allergy, which more common. This type is not very serious and usually causes a rash that begins after a few days of taking a drug.
** Call 911 or contact your physician if you have any of the above symptoms.
Can I be tested for a drug allergy?
If your doctor suspects you have an immediate drug allergy, he or she might send you for allergy skin tests.
If you have a reaction that consists only of a rash (the type that is not serious), your doctor might want to send you to do a “drug challenge test.” For this test, the allergist will have you take a small amount of the drug that caused the rash while he or she observes you.
What are hives? – Hives are raised, red patches of skin that are usually itchy. Hives can be due to an allergy or other causes. In most cases, hives come and go within a few hours but in some people they will show up again and again. Some people who get hives also get a condition called “angioedema.” Angioedema is puffiness or swelling which usually happens in the face, eyelids, ears, mouth, hands, feet, or genitals.
Why did I get hives? — If you just got hives for the first time, you might have a new allergy to something. If your hives are caused by an allergy, you will need to avoid whatever you are allergic to.
Hives can also be caused by:
See a doctor or call 911 – If you suddenly get hives or get puffy and also have any of these symptoms:
How are hives treated? — Hives usually will go away in a few days or weeks, but they may persist for month’s even years. If you do need treatment, the first step is to figure out if anything triggered the hives. Skin testing and/or lab work looking for causes can be very helpful.
To relieve itching, you can take medicines called antihistamines. These are the same medicines people usually take for allergies. There is also an injectable medicine for people with severe symptoms.
If you have severe hives or your hives will not go away, your doctor might suggest that you take some steroids (Prednisone) for a short period of time.
What is eczema?
Eczema, also referred to as “atopic dermatitis” is a skin condition that makes your skin itchy and flaky. Doctors do not know what causes eczema but most patients with eczema have allergies.
What are the symptoms of eczema?
Can I reduce my symptoms?
How is eczema treated?
Irritated skin can be caused by a variety of factors. These include immune system disorders, medications and infections. When an allergen is responsible for triggering an immune system response, then it is an allergic skin condition.
Atopic Dermatitis (Eczema)
Eczema is the most common skin condition, especially in children. It affects one in five infants but only around one in fifty adults. It is now thought to be due to “leakiness” of the skin barrier, which causes it to dry out and become prone to irritation and inflammation by many environmental factors. Also, some people with eczema have a food sensitivity which can make eczema symptoms worse. In about half of patients with severe atopic dermatitis, the disease is due to inheritance of a faulty gene in their skin called filaggrin. Unlike with urticaria (hives), the itch of eczema is not caused by histamine so anti-histamines do not control the symptoms. Eczema is often linked with asthma, allergic rhinitis (hay fever) or food allergy. This order of progression is called the atopic march.
Allergic Contact Dermatitis
Allergic contact dermatitis occurs when your skin comes in direct contact with an allergen. For instance, if you have a nickel allergy and your skin comes in contact with jewelry made with even a very small amount of nickel, you may develop red, bumpy, scaly, itchy or swollen skin at the point of contact.
Coming in contact with poison ivy, poison oak and poison sumac can also cause allergic contact dermatitis. The red, itchy rash is caused by an oily coating covering these plants. The allergic reaction can come from actually touching them, or by touching clothing, pets or even gardening tools that have come in contact with the oil.
Hives are an inflammation of the skin triggered when the immune system releases histamine. This causes small blood vessels to leak, which leads to swelling in the skin. Swelling in deep layers of the skin is called angioedema. There are two kinds of urticaria, acute and chronic. Acute urticaria occurs after eating a particular food or coming in contact with a particular trigger. It can also be triggered by non-allergic causes such as heat or exercise, as well as medications, foods or insect bites. Chronic urticaria is rarely caused by specific triggers and so allergy tests are usually not helpful. Chronic urticaria can last for many months or years. Although they are often uncomfortable and sometimes painful, hives are not contagious.
Angioedema is swelling in the deep layers of the skin. It is often seen together with urticaria (hives). Angioedema many times occurs in soft tissues such as the eyelids, mouth or genitals. Angioedema is called “acute” if the condition lasts only a short time such as minutes to hours. Acute angioedema is commonly caused by an allergic reaction to medications or foods. Chronic recurrent angioedema is when the condition returns over a long period of time. It typically does not have an identifiable cause.
Hereditary angiodema (HAE) is a rare, but serious genetic condition involving swelling in various body parts including the hands, feet, face, intestinal wall and airways. It does not respond to treatment with antihistamines or adrenaline so it is important to go see a specialist.
Skin conditions are one of the most common forms of allergy treated and managed by an allergist / immunologist, a physician with specialized training and expertise to accurately diagnose your condition and provide relief for your symptoms.
What is latex allergy?
Latex is a milky white fluid produced by rubber trees that grow in South America. Latex can be used to manufacture many items that we use in medicine and everyday life including gloves, balloons, rubber bands, car tires, and condoms. During recent years, allergic reaction to latex have been reported with increasing frequency, especially in health care professionals and patients.
The most common type of reaction to latex is a contact dermatitis. In this type of reaction, an individual has itching, redness or scaling of the skin wherever latex has come into contact. This may occur quickly but usually takes a few hours or days to develop. The second type of latex is an immediate, potentially life threatening reaction that is mediated by an allergy antibody (IgE) to latex. In this type of reaction, an individual may have shortness of breath, throat closing, angioedema (swelling), hives, or loss of consciousness when contacting latex. The greatest danger in this type of reaction occurs when latex contacts mucus membranes or moist areas like the mouth, eyes, nasal passages, respiratory tract because more latex can be absorbed quickly.
How is treated?
Eosinophilic (ee-uh-sin-uh-fil-ik) esophagitis (EoE) is a recently recognized allergic/immune condition. A person with EoE will have inflammation or swelling of the esophagus. The esophagus is the tube that sends food from the mouth to the stomach.
In EoE, large numbers of white blood cells called eosinophils are found in the tissue of the esophagus. Normally there are no eosinophils in the esophagus. EoE can occur at any age and most commonly occurs in Caucasian males. The symptoms of EoE vary with age. In infants and toddlers, you may notice that they refuse their food or are not growing properly. School-age children often have recurring abdominal pain, trouble swallowing or vomiting. Teenagers and adults most often have difficulty swallowing. The esophagus can narrow to the point that food gets stuck. This is called food impaction and is a medical emergency.
Allergists and gastroenterologists are seeing many more patients with EoE. This is due to an increase in the frequency of EoE and greater physician awareness. EoE is considered to be a chronic condition.
Other diseases can also result in eosinophils in the esophagus. One example is acid reflux.
What is angioedema? — Angioedema is a condition that causes puffiness in the tissue under the skin. People with angioedema might have swelling of the face, eyelids, ears, mouth, tongue, hands, feet, or genitals. Some people who get angioedema also get hives. Hives are red, raised patches of skin that are very itchy.
Sometimes, people have symptoms of angioedema when they are having a dangerous allergic reaction. Call for 9-1-1 if you suddenly have puffiness or hives plus any of the following:
Why did I get angioedema? — A common cause of angioedema is allergies. If you just got angioedema for the first time, it might be because you have a new allergy to something. Allergies to the following things can cause angioedema:
How is angioedema treated? — The treatment depends on how serious the symptoms are. If you get angioedema because of a dangerous allergic reaction, you will need to be treated in a hospital right away.
If your symptoms are mild, you might not need treatment. But you should try to figure out if anything triggered your symptoms. If so, you will need to avoid that trigger.
Your doctor might recommend that you take medicines called antihistamines or steroids, if angioedema was caused by a medication then your doctor should switch you to a different medication.
What are symptoms of immune deficiency? – Infections are common and just a part of everyday life. It’s normal to get a cold or a “stomach” bug every once in a while. But people with an immune deficiency can have a very different course than someone with an intact immune system.
Immune deficient patients may have unusual infections with uncommon viruses, fungi or bacteria. They may have more severe infections that involve the bloodstream or brain, requiring hospitalization. Or they may be sick for a lot longer or require several rounds or higher doses of medication to get better.
If you or your child has recurrent:
then you may need an immune evaluation.
Our goal in diagnosing an immune deficiency is to help patients find out:
Treatment for immune deficiency? – The goals of the medical treatment and supportive care are to reduce the frequency of infections, prevent complications from prolonged or unusual infections, and prevent an acute infection from becoming chronic and potentially causing irreversible organ damage. It is a team effort – the patient, family and members of the healthcare team must work together and effectively communicate among each other if these goals are to be accomplished. Treatment may involve antibiotics, vaccinations, immune supplementation and frequent checkups to monitor progress. Together, we can help patients with immune deficiency can lead happy, successful and productive lives.