Allergy and immunology is the area of medicine dedicated to the care and treatment of health concerns and conditions of the immune system, including allergic disease and related symptoms and reactions— from asthma, rhinitis, sinus problems, or seasonal allergies to life-threatening reactions to drugs, food, vaccines, and more. Allergy and immunology covers the hundreds of immune diseases that affect millions of people.
Allergy and immunology is the area of medicine dedicated to the care and treatment of health concerns and conditions of the immune system, including allergic disease and related symptoms and reactions—from asthma, rhinitis, sinus problems, food, latex, insect sting, or seasonal allergies to hives, itchy eyes, skin, life-threatening reactions to drugs, food, vaccines, and more. Allergy and immunology also covers the hundreds of immune diseases which affect millions of Americans.
According to Castle Connolly Top Doctor Sebastian Lighvani, MD, Director, New York Allergy & Asthma, PLLC; Clinical Assistant Professor at Weill Cornell Medical College; and Clinical Faculty, Lenox Hill Hospital, North Shore, New York, “Over the last few years, there have been major advancements in the field of Allergy and Immunology both in terms of our understanding of the underlying mechanisms of allergic disease as well as our approaches to managing these conditions.“
“As we herald a new era of “Precision Medicine”, our ability to tailor therapy for individual patients, in tandem with the advent of biologic agents such as monoclonal antibodies, will revolutionize the management of difficult-to-treat conditions such as severe asthma, hives, eczema, nasal polyps and food allergy,” says Dr. Lighvani.
“Another area of burgeoning research is in the use of immunotherapy in the management of life-threatening food allergies,” Dr. Lighvani adds. “Current treatment paradigms largely focus on avoidance of allergenic foods and treatment of systemic reactions. In the not so distant future, immunotherapy via oral, sublingual and epicutaneous routes will likely become mainstream, and enable patients to ingest allergenic foods without the risk of severe systemic reactions.’
The Differences Between Allergies and Colds
An allergy is medical condition that manifests as an adverse response in the body to food, drug, insect or seasonal or environmental allergens. Symptoms can range from mild to severe, from itchy or watery eyes, sneezing, hives, or coughing, to life-threatening anaphylaxis. In these severe cases, symptoms may include tightening of the air passages, swelling of the face, mouth, eyes, throat, severe vomiting, and even heart failure. Patients with a history of severe reactions, or at risk for anaphylaxis, must exercise caution around trigger allergens, and are advised to carry life-saving emergency medication, such as epinephrine, in the event of
“Allergies and colds or viral upper respiratory tract infections impact large portions of the general population and share symptoms such as nasal congestion, runny nose and sneezing. But there are some key clinical differences that can help distinguish between these very common conditions,” explains Dr. Lighvani.
“While allergies are typically associated with significant itching of the eyes, nose, throat and clear nasal discharge related to local histamine release, despite the frequently used lay term “hay fever,” allergy sufferers rarely experience actual fever which is a more typical feature of viral and/or bacterial upper respiratory infections,” Dr. Lighvani notes. Other classic symptoms of colds include general aches and pains, more profound fatigue, and sore throat.
Another differentiating feature of colds is the timeline of symptoms, Dr. Lighvani says. “Uncomplicated colds typically last 7-10 days before subsiding. In contrast seasonal allergies usually last several weeks to months, when triggered by seasonal pollens or can be present in a more perennial nature depending on the type of allergen (e.g. dust mites or your pets at home) and duration of allergen exposure,” he adds.
Specialized Training in Allergy & Immunology
Allergists and immunologists are the medical professionals who treat conditions related to allergies and the immune system. According to the American College of Physicians (ACP), doctors in this field must complete an additional two years of additional training in this subspecialty, after finalizing pre-med undergraduate studies, medical school, and a three-year residency in pediatrics or internal medicine. The ACP also notes that some doctors chose to undergo three years of combined allergy, immunology, and rheumatology training instead of the two-year option. Upon completion of their education in this field, allergists and immunologists are eligible to apply for board certification for the subspecialty.
For certain allergy and immunology conditions which may also affect other organs of systems of the body, an allergist may treat a patient in combination with other specialists who will perform related tests such as an ear, nose, and throat doctor (ENT) for allergic conditions affecting those areas of the body, or a gastroenterologist to help test for, diagnose and treat allergic conditions that affect the esophagus or other areas of the digestive or gastrointestinal systems.
The Allergy & Immunology/Body Connection
The immune system as a whole may affect the entire body. As such, allergists and immunologists who care for patients with allergic conditions or other immune diseases may treat related symptoms arising in many areas, from the eyes to the scalp, skin, nasal passages, lungs, or even bone marrow, which is inside the bones themselves. According to the latest data shared by the American College of Allergy, Asthma & Immunology, between 40 and 50 million people in the United States suffer from allergies, including allergic rhinitis.
In the not so distant future, immunotherapy via oral, sublingual and epicutaneous routes will likely become mainstream and enable patients to ingest allergenic foods without the risk of severe systemic reactions.
Sebastian Lighvani, MD., Castle Connolly Top Doctor
Treating a Broad Range of Allergy & Immunology Medical Conditions
The following is a list of some of the numerous conditions and areas of expertise which make up the field of medicine of allergy and immunology. As there are 300 different identified primary immune deficiency diseases (PIDD), in addition to various allergies to foods or drugs, the list below is a sample of some of the most common conditions and expertise in allergy and immunology:
- Acute severe asthma
- Allergic asthma
- Anaphylaxis
- Angioedema
- Atopic dermatitis
- Autoimmune disease
- Celiac disease
- Childhood asthma
- Chronic cough
- Chronic Granulomatous Disease (CGD)
- Chronic Obstructive Pulmonary Disease (COPD)
- Conjunctivitis, allergic
- Eczema
- Food intolerance
- Food Protein-Induced Enterocolitis Syndrome (FPIES)
- Hay fever
- Hereditary Angioedema (HAE)
- Histamine toxicity
- Hives
- Hypereosinophilic Syndrome (HES)
- Lactose intolerance
- Latex allergy
- Nonallergic rhinitis
- Ocular allergy
- Occupational asthma
- Oral allergy syndrome
- Pollen Fruit Syndrome (PFS)
- Primary Immunodeficiency Diseases (PIDD)
- Pruritus
- Severe combined immunodeficiency
- Secondary immune deficiency disease
- Selective IgA deficiency
- Sinusitis
- Stevens-Johnson Syndrome
- Stinging insect allergy
Allergy & Immunology Tests, Procedures, and Surgeries
Allergists and immunologists may use one or several different types of tests or procedures to diagnose and treat patients, including the following:
- Advanced component testing: Tests for common food allergens including nuts, milk and eggs.
- Airway inflammation testing
- Allergen immunotherapy including allergy shots, drops and tablets for desensitization to environmental allergens such as dust, pollen and pets.
- Comprehensive immune function testing: Tests for assessment of recurrent or severe infections.
- Drug testing and challenge procedures: Tests for allergies to antibiotics and local anesthetics.
- Insect allergy testing: Tests including evaluation of anaphylaxis to bee stings and fire ants.
- Patch testing: Screens for allergic contact dermatitis to metals such as nickel and gold, and chemicals such as additives in cosmetics, household items, and occupational allergens such as rubber, dyes, foods and drugs.
- Pulmonary function tests (PFT): Tests for assessment of asthma and lung disorders.
- Rhinolaryngoscopy: Tests for assessment of conditions such as sinus disease, cough, vocal cord dysfunction and laryngopharyngeal reflux.
- Skin and blood tests: Tests for food and environmental allergies.
- The use of biologics for targeted therapy of severe asthma, hives, eczema and nasal polyps.
