The Department of Clinical Immunology and Allergy at the Royal Adelaide Hospital provides a specialist service for the diagnosis and management of allergic and immunologic diseases affecting the respiratory system, skin, gastrointestinal tract and other systems.
For any patients who require emergency/immediate assessment, they should be sent directly to the emergency department. Furthermore there are immunologists available on call.
Relative conditions include:
- Anaphylaxis
- Angioedema with threat to the airway
- Acute severe asthma
- Autoimmune disease/vasculitis with organ threat
URGENT REFERRALS
For any urgent referrals please contact the RAH switchboard (7074 0000)
During office hours: Ask for Allergy and Immunology Registrar to discuss the patient
After hours: Ask for an On call Immunology Consultant to discuss an urgent clinic appointment
Outpatient information
The Department of Clinical Immunology and Allergy provides a specialist service for the diagnosis and management of allergic and immunologic diseases affecting the respiratory system, skin, gastrointestinal tract and other systems.
Outpatient referrals should be faxed to (08) 7074 6247.
For further information / appointment queries, contact the Outpatient Call Centre on 1300 153 853.
Our Clinical Immunologists deal with conditions in 3 main areas:
- Allergy - immunological reaction against harmless substances
- Immunodeficiency - results in an increase in the frequency or severity of infections
- Autoimmunity – immunological reaction against the self.
We provide outpatient clinical services as well as the 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- LOC, collapse, admitted to hospital Cause- known, unknown, avoidable Recurrence Has/has not EpiPen, training |
| 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 |
| Drug/Contrast Allergy | Urgent Semi-Urgent Non-Urgent | Urgent indication for suspected drug allergen Multiple allergies/limited options Nature of previous adverse reactions |
|
| 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 |
| 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 |
Outpatient Services offered
By referral from primary care/hospital/other specialists:
- General allergy/immunodeficiency/autoimmunity clinic
- Private allergy/immunodeficiency/autoimmunity clinics
- Stinging insect allergy clinic.
BY Referral from ed/primary care:
- Rapid review anaphylaxis clinic
- Immunodeficiency clinic (patients receiving replacement immunoglobulin therapy)
- Immunology/Dermatology clinic.
tertiary referral:
- Immunodeficiency clinic (patients receiving replacement immunoglobulin therapy)
- Immunology/Dermatology clinic.
Services we provide / clinical conditions appropriate for referral:
- Anaphylaxis to drugs, insects, foods and unknown causeUrticaria 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).
Wayfinding (clinic or department location)
Tuesday afternoon clinics are held in Wing 5 East E, while all other clinic will be run through the Medical Day Unit on level 3.
Head of service / other relevant staffing information
Head of Unit
- Dr William Smith
Nurse Unit Manager
- Paul Georgiou
Consultants
- Dr William Smith
- Dr Frank Kette
- Dr Pravin Hissaria
- Dr Tatjana Banovic
Nurse Consultants
- Aida Ahmadie: Clinical Practice Consultant
- Noelene Davies: Advance Nurse Consultant – Immunoglobulin Program
| Day | Clinics | Doctors attending | Conditions seen |
| Monday pm Monday pm | Anaphylaxis Clinic
Allergy/Immunology Private Clinic | Registrar Dr Pravin Hissaria | Anaphylaxis Allergy/ Autoimmunity/ Immunodeficiency |
| Tuesday pm weeks 1-3
Tuesday pm Week 4 | Allergy/Immunology
Immunodeficiency Clinic | Dr William Smith Dr Frank Kette Dr Pravin Hissaria Dr Tatjana Banovic Registrar
Dr William Smith Dr Frank Kette Dr Pravin Hissaria Dr Tatjana Banovic Registrar | Allergy/ Autoimmunity/ Immunodeficiency
Immunodeficiency (on immunoglobulin) |
| Wednesday am | Sting Allergy Clinic | Dr Pravin Hissaria Registrar | Sting allergy |
| Thursday: No clinics | |||
| Friday pm | Allergy/Immunology Private Clinic Public Clinic | Dr William Smith Registrar | Allergy/ Autoimmunity/ Immunodeficiency |
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 (except where there is a good reason to suspect allergy, autoimmunity or immunodeficiency)
- 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 sheets for referring doctors
- Chronic Urticaria
- Insect sting allergy- large local reactions
- Food-related gastrointestinal symptoms/IBS
- Rhinitis (in preparation)
- When to suspect immunodeficiency (in preparation).
Further Information
Useful links:
- ASCIA- Australasian Society for Clinical Immunology and Allergy
- A&AA- Allergy & Anaphylaxis Australia
PRIVATE SERVICES:
- AllergySA
Dr William Smith
259 The Parade, Beulah Park, SA 5065 Ph: 8331 2711, Fax: 8331 2788
reception@allergysa.com.au, www.allergysa.com.au
- Adelaide Immunology and Allergy Centre
Dr Frank Kette 96 Unley Road, Unley SA 5061 Ph.8373 2422 Fax