Allergy and Clinical Immunology

Frequently Asked Questions

A visit to the allergy clinic

How do I know if I need to see an allergist?

What other kinds of diseases do allergists treat?

What kind of examination will I have in the allergy clinic?

Will I have skin tests?

Can RAST tests be done in place of skin testing?

What other tests may be needed?

Do all patients need allergy shots?

How old does a child have to be for an allergy evaluation?

A visit to the allergy clinic
Patients with allergic or immunologic problems involving the respiratory system, the skin and sometimes the digestive system may be referred to the Allergy Division by their family doctor or other medical specialist. Some of our patients are self-referred, for example, those with obvious asthmatic wheezing or “hay fever” symptoms that they have been unable to control with over-the-counter medications.

The senior staff physicians in the Allergy Clinic have all received extensive training in allergic and immunologic diseases and as a result of that specialization have been certified by the American Board of Allergy and Immunology.

On occasions there are Texas A&M Medical School student or resident physicians who may see patients in the Allergy Clinic with a senior staff physician. Each student or resident is directly supervised by one of the senior staff physicians who also evaluate every patient.

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How do I know if I need to see an allergist?
Your family doctor will help you decide when an allergy consultation is appropriate. The most common allergic diseases, asthma and allergic rhinitis or “hay fever”, frequently can be treated by your family doctor. However, some patients will not respond adequately to common forms of treatment and will benefit by being referred to a specialist. If your symptoms are complicated by sinus, ear or chest infections, a referral is also often appropriate. Often simply knowing whether symptoms are due to true allergy or just an environmental sensitivity is important in choosing the correct treatment.

What other kinds of diseases do allergists treat?
Asthma and “hay fever” are the most common diseases treated by an allergist. In addition, other chronic respiratory symptoms and diseases of the skin such as hives and eczema are evaluated. Some of our patients have symptoms involving the digestive system that are due to food allergies. Drug allergies may need to be evaluated by an allergist. Systemic allergic reactions to insect stings should definitely be evaluated by an allergist. We are also interested in patients who have problems with the immune system that may appear as recurrent infections.

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What kind of examination will I have in the allergy clinic?
One of the most important aspects of an allergy evaluation is a thorough patient history. A detailed history can help us pinpoint the triggering agent of an allergic disease. For pediatric patients, it is highly preferable for the mother of the child to come for the initial visit.

The physical examination may include a “complete” physical or it may be limited to the system involved – eyes, ears, nose, sinuses, lungs and skin.

Will I have skin tests?
When a patient’s history and physical exam suggest the possibility of an allergic disease, allergy skin testing may be recommended. This consists of a series of “prick” tests on the upper back usually followed by a series of intradermal or superficial injections into the skin of the upper arms. The tests take approximately 45 minutes and the results will be available at the end of your allergy visit.

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Can RAST tests be done in place of skin testing?
Many patients ask about RAST testing because it is “new”. RAST testing looks for a specific allergic protein in the blood, just as skin testing looks for the same type of protein in the skin. We think that skin testing is preferable because, in our experience, it can be more accurate than RAST testing from a commercial laboratory and because skin test results are available immediately. Many patients find it intriguing to be able to “see with their own eyes” just how allergic they are to each allergen tested.

What other tests may be needed?
A nasal smear will be done on many new patients with nasal symptoms. Other tests often ordered include a chest x-ray, sinus x-ray and pulmonary function test. If there is a problem with recurrent infection, a variety of tests to evaluate the immune system will be needed. In addition, consultation with other specialists, for example dermatologist, otorhinolaryngologist, gastroenterologist, may be requested.

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Do all patients need allergy shots?
Many of the patients evaluated in the allergy clinic for respiratory allergies will benefit from allergy injection therapy (allergy desensitization). However, some patients may be well controlled with allergen avoidance techniques and appropriate symptomatic medication.

How old does a child have to be for an allergy evaluation?
Most allergic disease in children under age two years is caused by foods and the common household allergens of dust, mold and animal dander. If your family doctor or pediatrician suspects allergy and is unable to control the problem through environmental means, dietary manipulation or medication then he/she may make a referral to the allergy clinic. Skin testing is rarely positive prior to age six months, but an allergist may be able to assist in treatment of allergic or respiratory problems in young infants less than six months of age.

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