The Clinical Immunology Team:
Consultant
None
Specialist Nurses
Mrs Gail Menzies - Lead Clinical Specialist Nurse
Ms Lori McFarlane - Clinical Nurse Specialist
Administration team
Mrs Katie Wilson (secretary) katie.wilson26@nhs.scot
Immunology Specialist Nurse:
Tel : 01382 660111
Extension 54971
Email: tay.immopat@nhs.scot
We can continue to offer a range of services for patients with immune-related diseases, including:
• Investigation and management of Primary and Secondary immunodeficiencies
• Investigation and management of Clinical Allergy, including
anaphylaxis, angioedema, drug allergy, food allergy, immunotherapy and drug sensitisation.
• Investigation and management of systemic autoimmune conditions.
• Email, ward and telephone consultative service for GPs and hospital clinicians.
• Investigation of peri-operative anaphylaxis (in conjunction with Dr C Weir, Consultant Anaesthetist)
Clinical Immunology
CONTENT UNDER REVIEW
Who We Are
Who to Refer
| Condition | Referral Specialty |
|---|---|
| Primary Immunodeficiency | Respiratory Medicine |
| Hereditary Angioedema | Respiratory Medicine |
| Airways Allergy | Respiratory Medicine |
| Venom Allergy | ENT |
| Airborne Allergen | ENT |
| Skin Allergy | Dermatology |
| Peripoperative allergy | Anaesthetics |
Recurrent major infection. Please refer all of the following:
• Two major infections in 12 months (major = requires hospital admission)
• One major + 2 minor (minor = microbiologically proven and needs oral antibiotic) in 12 months
• Second episode of bacterial meningitis ever
• Infections (major or minor) in relative of patient with known primary immunodeficiency
• Patients with unexplained bronchiectasis and/or sinusitis
• Recurrent deep abscesses of the skin or internal organs
• Unexplained chronic mucocutaneous candidiasis
Recurrent severe boils (failed initial therapy; deep seated abscesses): Most are due to staphylococcal carriage or local disease (hidradenitis suppurativa). Rarely may be due to neutrophil or antibody deficiency. Refer all patients with deep-seated abscesses (liver, brain)
Anaphylaxis: Refer all patients with anaphylaxis (= allergic reaction with systemic features, hypotension, laryngospasm, bronchospasm). See NICE Guideline.
Angioedema in people NOT on ACE Inhibitors including hereditary angioedema: Angioedema may be caused by ACE inhibitors (up to 10% of patients): stop drug and wait 3 months. Refer if persists. All cases of hereditary angioedema should be referred. Acquired angioedema in the older population may be associated with lymphoma.
Food allergy — known or suspected: The following conditions currently have no contingency, as they require the skills of a trained clinical immunologist, However referral to Immunology can continue. The patients will be listed in order of date of referral. When the service resumes the patients will be contacted in date order of receipt of referral.
Condition:
• Food Allergy
• Drug Allergy
Who Not to Refer
HIV/AIDS (known or suspected):Refer to Adult Infectious Disease Service.
Recurrent minor infection: Recurrent minor viral infections will not be due to immunodeficiency and referral is not necessary: exclude stress, inadequate diet, iron deficiency
Recurrent superficial abscess/boil.
Angioedema in people taking ACE Inhibitors: Stop drug and wait 3 months as above.
Seasonal or perennial rhino-conjunctivitis resistant to usual therapy: Patients with allergic rhino-conjunctivitis who fail to respond to maximal medical therapy (oral anti-histamines + nasal steroid + eye drops) should be referred to ENT. Ensure that nasal steroids are used with head forward looking at feet. Send a serum sample to the immunology laboratory for specific IgE (previously known as RAST) to common aeroallergens and for total IgE.
Eczema: Refer to Dermatology.
Asthma: Refer to Respiratory Medicine.
Asplenic patients: Guidelines for the management of asplenia are available from ‘The Green Book’.
Recurrent minor infection: Recurrent minor viral infections will not be due to immunodeficiency and referral is not necessary: exclude stress, inadequate diet, iron deficiency
Recurrent superficial abscess/boil.
Angioedema in people taking ACE Inhibitors: Stop drug and wait 3 months as above.
Seasonal or perennial rhino-conjunctivitis resistant to usual therapy: Patients with allergic rhino-conjunctivitis who fail to respond to maximal medical therapy (oral anti-histamines + nasal steroid + eye drops) should be referred to ENT. Ensure that nasal steroids are used with head forward looking at feet. Send a serum sample to the immunology laboratory for specific IgE (previously known as RAST) to common aeroallergens and for total IgE.
Eczema: Refer to Dermatology.
Asthma: Refer to Respiratory Medicine.
Asplenic patients: Guidelines for the management of asplenia are available from ‘The Green Book’.
How to Refer
General Practice
National Referring Tool
SCI Gateway
National Referring Tool
SCI Gateway
Alternatives to Referral
Clinical Advice option available via SCI Gateway.
Patients already known to the Service can contact the Immunology Specialist Nurses using Tay.immohpat@nhs.scot. This inbox is checked on working weekdays and enquires are responded to within 48 hours. Patients not currently known to the Clinical Immunology Service should direct their request to their GP in the first instance.
Patients already known to the Service can contact the Immunology Specialist Nurses using Tay.immohpat@nhs.scot. This inbox is checked on working weekdays and enquires are responded to within 48 hours. Patients not currently known to the Clinical Immunology Service should direct their request to their GP in the first instance.
Useful Resources
Clinical Immunology Service Webpage
Clinical Immunology Service Patient Information
(Links top the following awaited)
Advice on ACE inhibitors
Advice on chronic spontaneous angioedema
Advice on chronic spontaneous urticaria/angioedema
Clinical Immunology Service Patient Information
(Links top the following awaited)
Advice on ACE inhibitors
Advice on chronic spontaneous angioedema
Advice on chronic spontaneous urticaria/angioedema