Clinical Immunology and Allergy Unit

The Immunology Service provides facilities for the investigation, diagnosis and treatment of a wide range of immunological disorders including but not limited to:

• Antibody deficiency – primary and secondary
• Other rarer immune deficiencies e.g. combined immune deficiency, neutrophil defects, complement deficiency
• Hereditary and Acquired C1 inhibitor deficiency

Services include:

• Consultant led Immunology outpatient clinics for investigation and monitoring
• Joint respiratory and immunology clinics
• Immunology transition clinics
• Nurse led Immunoglobulin replacement therapy - either via the intravenous or subcutaneous route
• Home Immunoglobulin replacement therapy training for suitable patients
• Emergency treatment (within our working hours) for C1 inhibitor deficiency
• Training for home treatment of C1 inhibitor deficiency in suitable patients
• Nasal brush biopsy to investigate for primary ciliary dyskinesia

The Allergy service provides diagnosis, treatment, support and advice for patients with a variety of allergic disorders including but not limited to:

• Wasp/Bee venom allergy
• Drug allergy (including antibiotics, local and general anaesthetics)
• Latex allergy
• Allergen-induced asthma
• Aspirin exacerbated respiratory disease
• Allergic rhinitis
• Urticaria (Hives)
• Angioedema (Swelling)
• Anaphylaxis
• Mastocytosis

Services include:

• Written emergency treatment plans
• Training and provision of information leaflets aimed at reduction / avoidance of the allergen where possible
• Training in the correct use of antihistamines, use of adrenaline auto-injectors and nasal sprays
• Specialist Dietetic advice of food avoidance, elimination diets and nutritional advice
• Allergy skin testing
• Allergen challenge testing
• Subcutaneous desensitisation therapies
• Desensitisation to aspirin
• Omalizumab injections for severe chronic spontaneous urticaria

Skin Prick Testing

Depending on your clinical history, you may require skin prick testing but this is not always necessary. This is a painless procedure where a drop of the allergen, food or drug is placed on the skin and a tiny lancet is used to pin prick at the skin surface. This is left for 15 minutes and you are advised not to scratch or touch the area. The skin tests are then read and the doctor will review you with the results. The positive skin prick test will be like an itchy hive. The redness and itching will subside fairly quickly. An antihistamine can be taken if necessary.

Allergens available for skin prick testing are:

• Aeroallergens; house dust mite, grass pollen, tree pollen, weeds, moulds, fungi, cat, dog
• Wasp and bee venom
• Latex
• Nuts – peanut, almond, hazelnut, walnut, brazil, pistachio, cashew
• Shellfish/Fish – mussel, oyster, shrimp, lobster, crab, cod, tuna, mackerel
• Meat – chicken, pork
• Other foods: Wheat, milk, egg, soya, barley, lupin, oat, rye

Specialist Dietician

The Dietician is involved in the assessment, diagnosis and education of patients with all types of food hypersensitivity and is responsible for:

• Use of appropriate exclusion diets to diagnose specific food intolerances
• Education of patients on how to follow appropriate exclusion diets
• Assessment of nutritional adequacy and advice on nutritional supplementation
• Education of patients on dietary modification for irritable bowel syndrome
• Development of food challenges to aid diagnosis of food allergy
• Nutritional management of immunology patients
• Provide advice on more general dietetic problems e.g. diabetes, nutritional support, coeliac disease where required If you have or are likely to have a food intolerance, it can be helpful to bring along a food and symptom diary kept over a couple of weeks, as these can help identify patterns and reaction.

When you arrive for your appointment, please check in at reception and then take a seat in the waiting area.

You will be called by one of the trained and experienced clinic staff for your consultation.

The Doctor or Nurse will ask you questions about your symptoms and your medical history. If needed, tests may be carried out e.g. a blood test.

As part of your investigations, you may need to undergo skin prick testing.

Please allow up to 2 hours for your appointment.

The Clinical Immunology and Allergy Unit is wheelchair friendly, a hearing induction loop is available upon request, toilet facilities are available, and there are various catering facilities and retail outlets throughout the hospital campus.

We are committed to providing a safe and secure environment for both staff and patients. Our staff work here to care for others - being victims of violence is not part of their job. The organisation fully supports the NHS Violence Prevention and Reduction Standard therefore, any form of violence will not be tolerated.

If a medical condition prevents you from using private or public transport, please ring the following non-emergency transport providers one week before your appointment:

If you are registered with a GP in:

• Yorkshire – call Yorkshire Ambulance Service on 0333 1300 514
• Derbyshire – call EMAS on 0300 300 3434
• Nottinghamshire – call Arriva Transport on 0345 266 9662
• Lincolnshire – call Thames Ambulance Service on 0808 164 4586
• North and North East Lincolnshire – call Thames Ambulance Service on 0808 164 3030
• Leicestershire – call Thames Ambulance Service on 0345 241 3012
• Manchester/Cheshire – call 0800 032 3240

The Clinical Immunology & Allergy Unit (CIAU) is located in a separate unit on the Northern General Hospital site in Sheffield (entrance number 19).

More details can be found in the directions to Northern General including where to park

Parking is limited at the hospital and we recommend you use public transport if you can. The H1 shuttle bus stops in the hospital grounds – more information can be found here https://www.travelsouthyorkshire.com/

There are several catering facilities available in various locations around the Northern General site. For directions to the unit click here

Finding the unit

• Enter via the Herries road entrance
• Proceed past the Mobility & Specialised Rehabilitation Centre (number 32) on your left and Eye Centre on your right
• Proceed past the Children’s Outpatients department (number 30) on the left
• The Clinical Immunology & Allergy Unit is located on the left hand side opposite the Sheffield Hand Centre
• Enter the unit through this entrance

Please read the information contained within your appointment letter and accompanying information sheet.

It is important that you contact us with appointment changes or cancellations with as much notice as possible. We are under extreme pressure for appointments and to provide timely reviews, we need to utilise them as best we can.

When you attend your appointment, please bring:

• Your appointment letter
• A list of your medication including how much you take and how often
• Glasses or hearing aids if used
• Your up to date mobile number and email address

Prior to your allergy appointment, please stop antihistamines for 48 hours. If you feel you are unable to manage without them, please telephone the unit on 0114 2266963.

We have certain allergens available for skin prick testing, but we cannot provide all potential allergens. Please see the section on skin prick testing for a list of the allergens available. If you have had a problem with a food which is not on our list for testing, you can bring up to 5 food items with you to your appointment as it may be possible to test for this. Please ensure you do not handle the food and ask another person to wrap it for you.

If you have had allergic symptoms on exposure to a particular drug recently and you still have the drug at home, please bring the medication with you as it may be possible to use this for testing. If you no longer have the drug, we will order this for testing if this is necessary.

Please contact us if you wish to discuss any desired changes to your treatment/care so we can arrange either a callback or face-to-face follow-up appointment.

Please contact us if you are admitted to another hospital to ensure specialist input is provided if necessary. Always take a copy of your clinic letters for any hospital visits.

Depending on your clinical history, you may require skin prick testing but this is not always necessary. This is a painless procedure where a drop of the allergen, food or drug is placed on the skin and a tiny lancet is used to pin prick at the skin surface. This is left for 15 minutes and you are advised not to scratch or touch the area. The skin tests are then read and the doctor will review you with the results. The positive skin prick test will be like an itchy hive. The redness and itching will subside fairly quickly. An antihistamine can be taken if necessary.

Allergens available for skin prick testing are:

• Aeroallergens; house dust mite, grass pollen, tree pollen, weeds, moulds, fungi, cat, dog
• Wasp and bee venom
• Latex
• Nuts – peanut, almond, hazelnut, walnut, brazil, pistachio, cashew
• Shellfish/Fish – mussel, oyster, shrimp, lobster, crab, cod, tuna, mackerel
• Meat – chicken, pork
• Other foods: Wheat, milk, egg, soya, barley, lupin, oat, rye

Specialist Dietician

The Dietician is involved in the assessment, diagnosis and education of patients with all types of food hypersensitivity and is responsible for:

• Use of appropriate exclusion diets to diagnose specific food intolerances
• Education of patients on how to follow appropriate exclusion diets
• Assessment of nutritional adequacy and advice on nutritional supplementation
• Education of patients on dietary modification for irritable bowel syndrome
• Development of food challenges to aid diagnosis of food allergy
• Nutritional management of immunology patients
• Provide advice on more general dietetic problems e.g. diabetes, nutritional support, coeliac disease where required If you have or are likely to have a food intolerance, it can be helpful to bring along a food and symptom diary kept over a couple of weeks, as these can help identify patterns and reaction.

Research and development

We are constantly trying to improve the quality of treatments provided for patients and research is an important part of the process. Your doctor may discuss research projects with you and ask if you would be willing to be involved. This is entirely voluntary and you will be able to discuss the detail of any research project with your doctor.

Training at the hospital

As a teaching hospital, we have a responsibility to train future doctors, nurses and other health professionals. This means that students may be present during your treatment and be involved in your care. All our students work under the supervision of a qualified member of staff. By allowing students to be involved in your care you can make a valuable contribution to their training. If you prefer not to, please tell a member of staff as soon as possible. You have a right to do this, and your decision will not affect your treatment in any way.