The Department of Clinical Immunology and Allergy at the Royal Adelaide Hospital (RAH) provides a specialist service for the diagnosis and management of allergic and immunologic diseases.
The following conditions are medical emergencies and require immediate transfer to the RAH emergency department. Furthermore there are immunologists available on call.
Relevant conditions include:
- Anaphylaxis
- Angioedema with threat to the airway
- Acute severe asthma
- Autoimmune disease/vasculitis with organ threat
URGENT REFERRALS
Immunologists are available on call for urgent consultation or to discuss urgent clinic referrals:
Contact the RAH switchboard: (08) 7074 0000
During office hours: Ask for Allergy and Immunology Registrar.
After hours: Ask for the Immunology Consultant on call.
Outpatient information
RAH Outpatient referrals should be faxed to (08) 7074 6247.
For further information / appointment queries, contact the Outpatient Call Centre on 1300 153 853.
Clinical Immunologists deal with conditions in 3 main areas:
- Allergy - immunological reaction against harmless substances
- Immunodeficiency - increase in the frequency or severity of infections
- Autoimmunity – immunological reaction against the self.
We provide outpatient clinical services as well as consultation to hospital inpatients, day-patient admissions for procedures, and inpatient admissions to the medical ward under an Immunology consultant.
Our services / procedures:
- Clinical consultation
- Skin prick testing for allergy diagnosis
- Immunotherapy/Desensitisation for allergy treatment
- Challenge testing for diagnosis of food, drug allergy.
Condition | Likely Triage Category | Information required to determine urgency/ Prerequisite information |
Anaphylaxis | Rapid Access Urgent Semi-Urgent | Severity– eg. hypotension, collapse adrenaline treatment, admitted to hospital Cause- known, unknown, avoidable Recurrence Has/has not EpiPen |
Food allergy | Semi-Urgent Non-Urgent | Severity of reactions Known/unknown food Multiple foods Nutritional impact |
Rhinitis/Sinusitis | Semi-Urgent Non-Urgent | Interference with daily activities Response to medications Nasal obstruction, anosmia Sinus infections |
Asthma | Urgent Semi-Urgent Non-Urgent | Severity of attacks, symptoms Response to medications Likely allergic triggers |
Assessment for immunodeficiency | Semi-Urgent Non-Urgent | Severity, frequency of infections Immunoglobulin levels Infectious pathogens, antibiotic requirement Atypical infections, family history |
Drug/Contrast Allergy | Urgent Semi-Urgent Non-Urgent | Urgent indication for suspected drug allergen Multiple allergies/limited options Nature of previous adverse reactions |
Chronic Urticaria | Semi-Urgent Non-Urgent | Duration, severity of urticaria Association with systemic symptoms Response to antihistamines |
Angioedema | Urgent Semi-Urgent | Frequency, severity Involvement of airway |
Eczema | Non-Urgent | Primary referral to dermatology Allergic trigger suspected? |
Periodic fever/ Autoinflammatory syndrome | Semi-Urgent Non-Urgent | Fever, rash, organ involvement, family history |
Mast cell disorder | Urgent Semi-Urgent Non-Urgent | Anaphylaxis, recurrent mastocytosis attacks Organ, systemic involvement Predominant cutaneous involvement |
Vasculitis- GPA, EGPA | Urgent Semi-Urgent | New diagnosis, organ involvement, eosinophil counts, inflammatory markers |
Systemic autoimmune disease SLE, Sjogren’s syndrome, dermatomyositis | Urgent Semi-Urgent Non-Urgent | Active inflammation, organ threatening Unwell, progressive disease Positive blood tests without signs |
Services we provide / clinical conditions appropriate for referral:
- Anaphylaxis to drugs, insects, foods and unknown cause
- Urticaria and angioedema
- Hereditary Angioedema
- Drug allergy
- Allergic rhinitis, conjunctivitis
- Non-allergic rhinitis
- Allergic and non-allergic sinusitis, nasal polyposis
- Asthma, allergic and non-allergic
- Eczema
- Venom and aeroallergen immunotherapy
- Systemic vasculitis including GPA
- Food allergy
- Eosinophilic oesophagitis, gastroenteritis
- Mast cell disorders
- Immunological lung diseases such as bronchopulmonary aspergillosis, EGPA
- Systemic autoimmune disorders such as SLE, Sjogren’s syndrome, dermatomyositis
- Systemic autoinflammatory diseases
- Immunodeficiency, hereditary and acquired (not HIV).
Head of service / other relevant staffing information
Head of Unit
- A/Prof. William Smith
Nurse Unit Manager
- Hong Pin Tan (HP)
Consultants
- A/Prof. William Smith
- Dr Frank Kette
- A/Prof. Pravin Hissaria
- Dr Tatjana Banovic
- Dr Syed Ali
- Dr Chino Yuson
Nurse Consultants
- Aida Ahmadie: Nurse Consultant
- Nicolle Ginman: Nurse Consultant – Immunoglobulin Program
- Helen Mayger: Clinical Nurse
Day | Clinics | Doctors attending | Conditions seen |
Monday pm Monday pm | Anaphylaxis Clinic Allergy/Immunology Private Clinic | Registrar A/Prof. Pravin Hissaria | Anaphylaxis Allergy/ Autoimmunity/ Immunodeficiency |
Tuesday pm Weeks 1-3 | Allergy/Immunology | Dr Syed Ali | Allergy/ Autoimmunity/ Immunodeficiency |
| Tuesday pm Week 4 | Immunodeficiency Clinic | A/Prof. William Smith Dr Frank Kette A/Prof. Pravin Hissaria Dr Tatjana Banovic Dr Syed Ali Registrars | Immunodeficiency (on immunoglobulin) |
Wednesday am | Sting Allergy Clinic | Dr Chino Yuson | Sting allergy |
Thursday: No clinics | |||
Friday pm | Allergy/Immunology Private Clinic Public Clinic | A/Prof. William Smith | Allergy/ Autoimmunity/ Immunodeficiency |
| Friday am/pm | Mount Barker Clinic | Dr Chino Yuson Registrar | Hopper Ant Sting Allergy Allergy/Autoimmunity/Immunodeficiency (Hills Region) |
WHAT WE DON’T SEE / CONDITIONS EXCLUDED FROM SERVICE:
- Irritable bowel syndrome/suspected food intolerance (except on referral or recommendation from gastroenterologist) (see information sheet)
- Large local reactions to insect stings (see information sheet)
- Chronic fatigue syndrome/multiple chemical sensitivity/fibromyalgia
- Contact dermatitis (refer to dermatology)
- Acute or chronic urticaria which has remitted (unless allergic cause suspected)
- Children under 18 yrs
- Patients being treated for same condition at other hospital.
Information for referring doctors
Fact sheets
- Chronic urticaria (PDF 952KB)
- Food-related gastrointestinal symptoms/IBS (PDF 952KB)
- Large local reactions to insect stings (PDF 950KB)
- Rhinitis (in preparation)
- When to suspect immunodeficiency (in preparation).
Referral guidelines for GPs
- Anaphylaxis (PDF 321KB)
- Angioedema (PDF 259KB)
- Chronic urticaria (PDF 266KB)
- Drug reactions (PDF 262KB)
- Hayfever (PDF 280KB)
- Primary immunodeficiency (PDF 307KB)
USEFUL LINKS
- Australasian Society for Clinical Immunology and Allergy (ASCIA)
- Allergy and Anaphylaxis Australia (A&AA)
- Allergy SA
Dr William Smith, Dr Chino Yuson, Dr Syed Ali
259 The Parade, Beulah Park, SA 5065, (Dr Smith, Dr Ali)
47 Orsmond Street, Hindmarsh SA 5007 (Dr Yuson)
Phone: (08) 8331 2711, Fax: (08) 8331 2788 (Beulah Park)
Phone: (08) 8312 6148, Fax: (08) 8312 6158 (Hindmarsh)
reception@allergysa.com.au, www.allergysa.com.au - Adelaide Immunology and Allergy Centre
Dr Frank Kette
96 Unley Road, Unley SA 5061
Phone: (08) 8373 2422, Fax: (08) 8373 6148
receptionaaic@tpg.com.au