The Department of Pediatric Immunology and Allergy is a specialty that deals with the diagnosis, treatment and follow-up of immunological, that is, immune system and allergic diseases in children between the ages of 0-18. In addition to many different diseases, immunological tests and HLA typing before transplantation are also performed by the physicians of this department by working together with the bone marrow and stem cell transplantation center.
In parallel, HLA typing, lymphocyte cross-match analysis and immunologic tests using the most up-to-date methods required for solid organ transplantation at the international level are also performed by the physicians of this department. Prevention of infectious epidemics that can deeply affect the society is also among the job descriptions of pediatric immunology and allergy department physicians.
Pediatric immunology and allergy physicians complete 6 years of medical school, 4 years of pediatric health and diseases specialization and 3 years of specialization in pediatric immunology and allergy diseases.
What is the Department of Pediatric Immunology and Allergy
The pediatric allergy department is a health unit specially equipped to diagnose and treat allergic reactions in children. Pediatric allergists have in-depth knowledge and experience in food allergies, asthma, eczema and other allergic conditions. These specialists create individualized treatment plans to control children’s allergy symptoms and improve their quality of life.
The Department of Pediatric Immunology and Allergy is the international center for the diagnosis and treatment of many immunologically based diseases such as immunodeficiency and infections. It is also the branch of science that deals with the diagnosis and treatment of allergic diseases caused by the interaction of genetic and environmental factors.
There are many immunologic and allergy-related diseases. These include allergic rhinitis, commonly known as allergic rhinitis, hay fever or spring fever; allergic and non-allergic bronchial asthma; food, drug, insect and skin allergies known as atopic dermatitis; recurrent wheezing attacks; and anaphylactic shock, a fatal and severe allergic reaction requiring emergency intervention.
While the weakness in the immune system, commonly known as the immune system, due to different reasons often manifests itself as frequent infectious diseases, allergic diseases often manifest themselves with the following symptoms.
- Skin itching
- Redness, blistering and swelling of the skin
- Eczema
- Recurrent dry cough and sneezing
- Shortness of breath
- Wheezing breathing
- Runny nose, itching and congestion
- Tearing, redness and itching of the eyes
- Abdominal pain
- Diarrhea
- Vomiting
- Presence of blood or mucus in the stool
- Tests performed in Pediatric Immunology and Allergy Department
Depending on the patient’s complaints, a physical examination is performed after a detailed history taken by the physician. Laboratory tests and radiological imaging methods are used when necessary. The tests frequently performed by the department physicians are as follows:
Prick Test:
This test, also known as the prick test, involves placing a drop of allergenic liquid on the back or the inner surface of the arm below the elbow. With the help of a sterile, pointed metal rod, in other words a lancet, a superficial scratch is made on the skin. This test, which is frequently applied, does not cause pain and results in a very short time, evaluates allergens caused by house dust allergens, plant pollens, pets such as cats, dogs and birds.
Intradermal Test:
In other words, the intradermal test is used to detect allergies caused by bee stings or medications. A very small amount of allergenic liquid, 0.01 – 0.02 ml, is injected under the skin with the help of a very fine-tipped insulin syringe into the arm or back. The possibility of a systemic reaction is increased by administering 4 or 5 antigens at the same time. The patient is left for 20 minutes with the injection site open. During this time, the patient is warned not to scratch these areas.
Patch Test:
Patch test is used in the diagnosis of contact dermatitis, that is, reactions to substances that come into contact with the external surface of the body, and allergic formations such as dermatitis and urticaria. The necessary allergens are placed in the relevant area of the adhesive tape, which is defined as a patch test unit and has small chambers at the bottom, and adhered to the back area.
The patch is removed approximately 2-3 days after the allergens in the chambers in the unit have contacted the body. During this period, the patient should not take a shower and should not engage in physical activity that increases sweating. In order to detect some late reactions, the patient should visit the physician again 2-3 days after the patch is removed.
Specific IgE Test:
It is a test performed in the blood against a specific allergen suspected in line with the patient’s history. Specific IgE is not a general allergy screening, but a type of test for certain groups of allergies. For example, Type 1 hypersensitivity reactions include hay fever, asthma, atopic dermatitis, rash, systemic anaphylaxis. In addition, test groups such as foods and food mixtures, epithelials and animal proteins, mixtures of epithelials and animal proteins, grasses, grains and pollen, some occupational allergens, mold fungal species and yeast mixtures, various tree pollen mixtures, weed and flower mixtures can be applied. This test is performed in the laboratory in blood taken from the patient.
Spirometry:
Spirometry, known as SFT, respiratory function test, is performed to evaluate diseases affecting heart and lung functions such as asthma, and to measure the capacity and functional status of the lungs. Basically, it is the measurement of how much the patient breathes into the lungs and how much of this breath is given back in a certain time interval. Before the pulmonary function test is performed, the patient should not be out of breath and should have returned to normal breathing. During the test, the nose is covered and a disposable mask is placed over the mouth.
The patient is asked to take a strong and very deep breath and the patient is asked to exhale on the physician’s signal. The test is repeated 3 times in this way and the necessary evaluation is made based on the best result. It is not recommended that patients are hungry or very full before the test. It is also not recommended to wear tight clothing that will prevent chest and abdominal movements, as this may cause inaccuracies in the tests. It is also important that the patient has not smoked or consumed alcohol in the 24 hours prior to the test so that the test result is not affected.
Rhinomanometry:
Rhinomanometry, also known as nasal breathing measurement, is a test to measure nasal airway resistance. In this way, the degree of possible obstruction and the changes and pressure in the airway are determined.
What is Immunotherapy Treatment
In addition to drug treatment, immunotherapy can be applied to patients with conditions such as allergic asthma, allergic rhinitis or bee allergy who meet the necessary criteria for treatment. Immunotherapy, also known as allergy vaccine or vaccine treatment, is applied especially in allergic patients who want to be protected from allergens and who cannot be controlled despite the use of medication or where side effects due to medication are observed. Depending on the age of the patient, tablet immunotherapy, sublingual drip vaccine or subcutaneous vaccine can be applied.
Tablet Immunotherapy:
It is an oral treatment that has increased in use in recent years. Allergens are administered daily using a tablet that dissolves under the tongue. The tablet is held in the mouth for 1 minute and then swallowed. Nothing should be eaten or drunk in the first 5 minutes after swallowing the medicine.
Sublingual Drops Vaccine:
Sublingual Immunotherapy is a method that can be administered by the patient himself/herself. The solution containing allergen solutions is dropped on the tongue and kept in the mouth for 2 minutes and then swallowed. Under the supervision of a physician, it can be administered initially every day and then 3 days a week.
Subcutaneous Vaccine:
In the application referred to as subcutaneous immunotherapy in the literature, the allergen solution is administered under the skin with a very fine-tipped syringe. Injections are given in the upper outer part of the arm, each time in a different arm, and the patient is observed for the first half hour. It is usual to have a lump-like hard swelling at the injection site.
Do not neglect to have regular check-ups for early diagnosis and treatment of allergies, immunodeficiency and many other diseases.