What is an immunologist?
An immunologist is a specialized physician who has already completed three years of internal medicine or pediatrics training followed by a two-year allergy and immunology program. Immunologists are trained to diagnose and treat conditions that are the result of a malfunctioning immune system.
What does an immunologist diagnose?
An immunologist diagnoses and treats some very common conditions, such as seasonal allergies. They are also trained to recognize, monitor, and treat rare conditions that lead to an overactive or underactive immune system. Some of the conditions that immunologists diagnose are:
- Asthma
- Seasonal allergies
- Severe allergic reactions to foods (anaphylaxis)
- Mast cell activation disorders
- Autoimmune vasculitis
- Eosinophilic esophagitis
- Celiac disease
- Severe combined immunodeficiency
- Other congenital autoimmune conditions that lead to severe illness early in childhood
Why would you see an immunologist?
One of the most common reasons to see an immunologist is for further workup and treatment of seasonal allergies or severe sensitivity to foods. While these conditions can be treated initially by your primary care doctor, they may refer you to an immunologist if they feel you can benefit from more intense treatment.
The other reason to see an immunologist is if another physician suspects that you have a complex immune system disease that is leading to an overactive immune system, which is damaging your organs, or an underactive immune system that is causing severe infections.
What happens at an immunology appointment?
An immunology appointment is like any other doctor’s visit. An immunologist will go into much more detail regarding your medical history, birth history, and family history. This information can help them to narrow down which known immunological condition could be causing your symptoms.
Almost all of these diagnoses are confirmed with blood tests. These tests are no different from a typical blood draw, but may take days to weeks for analysis. If you have a condition that is causing the immune system to attack a specific organ or part of the body, a biopsy of that organ or area may need to be done. This is usually done on a follow up visit and would not be done on the initial visit.
For simpler conditions, such as seasonal allergies, injections to help reduce allergy symptoms can be done in the doctor’s office. Immunologists may also recommend specific eye drops, ear drops, or oral medications to help manage symptoms.
What questions should I ask my immunologist?
You should ask your immunologist about the treatments that they prescribe. Some treatments are more effective if you avoid certain medications or foods. Others may require you to avoid contact with sick individuals or return for follow-up blood work at a specific time. Asking these questions about your treatment can help you to avoid making decisions that could reduce the efficacy of your treatment or cause you harm.
How does an immunologist test your immune system?
Almost all tests for immune system function are blood tests. The blood contains the cells and proteins that are responsible for the function of the immune system. By using machines that are designed to separate out and analyze the cells and proteins, immunologists can determine if any are absent, defective, or overactive.
These tests need to be done on specialized machines that are only in a few labs around the country. This means that these tests take several days to weeks to return results. It can be a long and slow process to find a diagnosis in the case of an immune-system-related illness due to the rarity and complexity of these conditions.
