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Allergy & Immunology

 

The Department of Clinical Immunology and Allergy at the Royal Adelaide Hospital provides a specialist service for the diagnosis and management of allergic and immunologic diseases.

The following conditions are medical emergencies and require immediate transfer to the emergency department. Furthermore there are immunologists available on call.

Relative conditions include:

  • Anaphylaxis
  • Angioedema with threat to the airway
  • Acute severe asthma
  • Autoimmune disease/vasculitis with organ threat

URGENT REFERRALS

Immunologists are available on call for urgent consultation or to discuss urgent clinic referrals: 

Contact the RAH switchboard (08) 7074 0000)

During office hours: Ask for Allergy and Immunology Registrar.

After hours: Ask for the Immunology Consultant on call.

Outpatient information

Outpatient referrals should be faxed to (08) 7074 6247.

For further information / appointment queries, contact the Outpatient Call Centre on 1300 153 853.

Clinical Immunologists deal with conditions in 3 main areas:

  • Allergy - immunological reaction against harmless substances
  • Immunodeficiency - results in an increase in the frequency or severity of infections
  • Autoimmunity – immunological reaction against the self.

We provide outpatient clinical services as well as the consultation to hospital inpatients, day-patient admissions for procedures, and inpatient admissions to the medical ward under an Immunology consultant. 

Our services / procedures:

  • Clinical consultation
  • Skin prick testing for allergy diagnosis
  • Immunotherapy/Desensitisation for allergy treatment
  • Challenge testing for diagnosis of food, drug allergy.

Condition

Likely Triage Category

Information required to determine urgency/

Prerequisite information

Anaphylaxis

Rapid Access

Urgent

Semi-Urgent

Severity level of consciousness. (LOC), collapse, admitted to hospital

Cause- known, unknown, avoidable

Recurrence

Has/has not EpiPen, training

Food allergy

Semi-Urgent

Non-Urgent

Severity of reactions

Known/unknown food

Multiple foods

Nutritional impact

Rhinitis/Sinusitis

 

Semi-Urgent

Non-Urgent

Interference with daily activities

Response to medications

Nasal obstruction, anosmia

Sinus infections

Asthma

Urgent

Semi-Urgent

Non-Urgent

Severity of attacks, symptoms

Response to medications

Likely allergic triggers

Assessment for immunodeficiency       

Semi-Urgent

Non-Urgent

Severity, frequency of infections

Immunoglobulin levels

Infectious pathogens, antibiotic requirement

Atypical infections

Drug/Contrast Allergy

Urgent

Semi-Urgent

Non-Urgent

Urgent indication for suspected drug allergen

Multiple allergies/limited options

Nature of previous adverse reactions

Chronic Urticaria

Semi-Urgent

Non-Urgent

Duration, severity of urticaria

Association with systemic symptoms

Response to antihistamines

Angioedema

Urgent

Semi-Urgent

Frequency, severity

Involvement of airway

Eczema

Non-Urgent

Primary referral to dermatology

Allergic trigger suspected?

Periodic Fever/

Autoinflammatory syndrome

Semi-Urgent

Non-Urgent

Fever, rash, organ involvement

Mast cell disorder

Urgent

Semi-Urgent

Non-Urgent

Anaphylaxis, recurrent mastocytosis attacks

Organ, systemic involvement

Predominant cutaneous involvement

Vasculitis- GPA, EGPA

Urgent

Semi-Urgent

New diagnosis, organ involvement, eosinophil counts, inflammatory markers

Systemic autoimmune disease

SLE, Sjogren’s syndrome, dermatomyositis

Urgent

Semi-Urgent

Non-Urgent

Active inflammation, organ threatening

Unwell, progressive disease

Positive blood tests without signs

Outpatient services offered

BY REFERRAL FROM PRIMARY CARE/HOSPITAL/OTHER SPECIALISTS:
  • General allergy/immunodeficiency/autoimmunity clinic
  • Private allergy/immunodeficiency/autoimmunity clinics
  • Stinging insect allergy clinic.
BY REFERRAL FROM ED/PRIMARY CARE:
  • Rapid review anaphylaxis clinic
TERTIARY REFERRAL:
  • Immunodeficiency clinic (patients receiving replacement immunoglobulin therapy) 
  • Immunology/Dermatology clinic.

Services we provide / clinical conditions appropriate for referral: 

  • Anaphylaxis to drugs, insects, foods and unknown causeUrticaria and angioedema
  • Hereditary Angioedema
  • Drug allergy
  • Allergic rhinitis, conjunctivitis
  • Non-allergic rhinitis
  • Allergic and non-allergic sinusitis, nasal polyposis
  • Asthma, allergic and non-allergic
  • Eczema
  • Venom and aeroallergen immunotherapy
  • Systemic vasculitis including GPA
  • Food allergy
  • Eosinophilic oesophagitis, gastroenteritis
  • Mast cell disorders
  • Immunological lung diseases such as bronchopulmonary aspergillosis, EGPA
  • Systemic autoimmune disorders such as SLE, Sjogren’s syndrome, dermatomyositis
  • Systemic autoinflammatory diseases
  • Immunodeficiency, hereditary and acquired (not HIV).

Wayfinding (clinic or department location)

Tuesday afternoon clinics are held in Wing 5 East E, while all other clinic will be run through the Medical Day Unit on level 3.

Head of service / other relevant staffing information 

Head of Unit

  • Dr William Smith

Nurse Unit Manager

  • Paul Georgiou

Consultants

  • Dr William Smith
  • Dr Frank Kette
  • Dr Pravin Hissaria
  • Dr Tatjana Banovic

Nurse Consultants

  • Aida Ahmadie: Clinical Practice Consultant 
  • Noelene Davies: Advance Nurse Consultant – Immunoglobulin Program

Day

Clinics

Doctors attending

Conditions seen

Monday pm

Monday pm

Anaphylaxis Clinic

 

Allergy/Immunology Private Clinic

Registrar

Dr Pravin Hissaria

Anaphylaxis

Allergy/

Autoimmunity/

Immunodeficiency

Tuesday pm weeks 1-3

 

 

 

 

 

Tuesday pm Week 4

Allergy/Immunology

 

 

 

 

 

Immunodeficiency Clinic

Dr William Smith

Dr Frank Kette

Dr Pravin Hissaria

Dr Tatjana Banovic

Registrar

 

Dr William Smith

Dr Frank Kette

Dr Pravin Hissaria

Dr Tatjana Banovic

Registrar

Allergy/

Autoimmunity/

Immunodeficiency

 

 

 

Immunodeficiency

(on immunoglobulin)

Wednesday am

Sting Allergy Clinic

Dr Pravin Hissaria

Registrar

Sting allergy

Thursday: No clinics

Friday pm

Allergy/Immunology Private Clinic

Public Clinic

Dr William Smith

Registrar

Allergy/

Autoimmunity/

Immunodeficiency

WHAT WE DON’T SEE / CONDITIONS EXCLUDED FROM SERVICE:
  • Irritable bowel syndrome/suspected food intolerance (except on referral or recommendation from gastroenterologist) (see information sheet)
  • Large local reactions to insect stings (see information sheet)
  • Chronic fatigue syndrome/multiple chemical sensitivity/fibromyalgia 
  • Contact dermatitis (refer to dermatology)
  • Acute or chronic urticaria which has remitted (unless allergic cause suspected)
  • Children under 18 yrs
  • Patients being treated for same condition at other hospital.

Information for referring doctors

Fact sheets
Referral guidelines for GPs 

USEFUL LINKS

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