Allergy and Immunology

Allergic reactions, which affect 30% of the world's population, and diseases such as rhinitis, asthma, urticaria/angioedema, and drug and food allergies, which are commonly seen as a result of these reactions, are significant public health problems that lower individuals' quality of life. The allergy and immunology medical unit carries out diagnosis and treatment practices for managing symptoms and disease processes associated with allergy and immune system disorders in adult patients.

What is Allergy and Immunology?

Allergy and immunology is a medical specialty focused on diagnosing allergic reactions, developing treatment plans, and managing diseases related to immune deficiencies. Allergy refers to the immune system’s exaggerated response to a generally harmless foreign substance after repeated exposure.

Also known as hypersensitivity, this condition may range from mildly uncomfortable symptoms to severe, life-threatening systemic reactions. The type and severity of symptoms depend on the level and route of exposure to the allergen, as well as individual sensitivity. In patients who develop serious systemic reactions, immediate medical intervention is critical.

Allergy and immunology specialists play an essential role in preventing and managing serious diseases and life-threatening responses, particularly in patients with severe allergies. Since hypersensitivity-related disorders can develop for various reasons, personalized approaches are applied in diagnosis, treatment, and prevention strategies.

What does the Allergy and Immunology Unit deal with?

The Allergy and immunology department is responsible for requesting the necessary tests and evaluations to identify the triggering substance and prevent reactions in allergic individuals. Depending on the allergen, one or more systems in the body may be affected. These immune system-mediated responses are more commonly observed on the skin and mucous membranes, which serve as the body’s first line of defense against environmental factors. The resulting sensitivity often leads to localized inflammation. Diagnosis is based on a comprehensive assessment of the patient’s symptoms, medical history, and test results. The treatment process is planned by identifying the specific allergens involved.

Common diseases treated in allergy and immunology units include:

Allergic Rhinitis

Affecting between 10% and 30% of the global population, allergic rhinitis results from non-infectious inflammation of the nasal mucosa. It often coexists with conditions such as nasal polyps, sinusitis, conjunctivitis, middle ear infections, upper respiratory tract infections, and sleep disturbances. Allergic rhinitis should not be underestimated, as it may increase the risk of developing asthma. Patients whose symptoms are not adequately controlled with conventional therapies (e.g., antihistamines, nasal steroids) should be referred to allergy and immunology specialists. Immunotherapy (desensitization) can significantly enhance quality of life, decrease the need for medication, and prevent asthma progression in this patient group.

Allergic Conjunctivitis

Allergic conjunctivitis, the most frequent cause of eye redness, affects over one million individuals globally. Airborne allergens can lead to mild-to-moderate symptoms or, in some cases, provoke more severe inflammation involving the cornea. As such, it is considered one of the allergic disorders requiring medical supervision and control.

Asthma

Asthma is a lifelong chronic inflammatory disease of the airways, characterized by bronchial obstruction and hypersensitivity to various stimuli. Allergic asthma is frequently observed in atopic individuals who are genetically predisposed to react to environmental allergens. The disease may interfere with daily activities and reduce the individual’s quality of life. If uncontrolled, asthma poses serious public health concerns and may become life-threatening. Correct diagnosis, appropriate treatment, and close monitoring are key to managing asthma effectively. In 5–10% of cases, standard treatments such as inhaled corticosteroids may be insufficient, and biological therapies administered by allergy and immunology experts can significantly improve patient outcomes.

Atopic Dermatitis (Eczema)

Atopic dermatitis is one of the most prevalent chronic inflammatory skin conditions. In genetically predisposed individuals, early signs typically include redness and itching. The disorder impairs the skin’s outer barrier due to dryness and flakiness, leaving it more susceptible to allergens and immune activation. Patients with eczema during infancy are at increased risk for developing allergic rhinitis and asthma later in life. Treatment focuses on preventing the progression of other atopic conditions, controlling inflammation, and restoring skin integrity to enhance quality of life.

Urticaria

Urticaria, marked by raised, red, itchy welts (hives), can present in acute or chronic forms. Acute episodes are often associated with food, drug, or insect allergies. However, many cases are idiopathic and may progress into chronic urticaria. Severe cases can be accompanied by angioedema. Moderate-to-severe cases should be evaluated by allergy specialists to achieve proper control. Beyond standard therapies (e.g., antihistamines, corticosteroids), biological agents may be used under specialist supervision to improve disease outcomes and enhance patient well-being.

Food Allergy

Food allergies affect an estimated 250 million people worldwide and can range in severity from mild symptoms to life-threatening reactions. Manifestations include atopic dermatitis, recurrent vomiting or diarrhea, urticaria, asthma attacks, and anaphylaxis. Reactions occur upon ingestion of allergenic food substances. Management involves identifying and eliminating the allergen from the diet and equipping the patient with an adrenaline auto-injector. In select pediatric cases—such as cow’s milk allergy—desensitization may be considered.

Drug Allergy

Drug allergies, responsible for over 20% of hospital admissions related to adverse drug reactions, arise from unpredictable hypersensitivity responses. Common triggers include pencillins, cephalosporins, sulfonamides, aspirin, and other NSAIDs. Clinical presentations vary widely depending on the drug, route of administration, and individual sensitivity. Prompt diagnosis and appropriate management are vital, as drug-induced anaphylaxis has a high mortality rate. If no alternative medications are available, desensitization protocols should be applied under specialist supervision.

Bee Sting Allergy

Bee sting allergies are common worldwide and may lead to localized or systemic reactions. Symptoms can range from localized redness and swelling to life-threatening systemic manifestations such as bronchospasm, laryngeal edema, or hypotension. Prompt diagnosis and intervention are crucial, as untreated systemic reactions can be fatal. Individuals with known sensitivity should undergo an allergic workup, and immunotherapy is a life-saving approach for those with a history of systemic reactions.

Anaphylaxis

Anaphylaxis is a severe, potentially fatal hypersensitivity reaction that typically follows exposure to medications, foods, or insect stings. The route of exposure affects the onset and severity of symptoms. Intravenous or injected medications may trigger symptoms within seconds, whereas oral ingestion may lead to delayed reactions. In critical cases, anaphylaxis can lead to unconsciousness or anaphylactic shock, with airway obstruction or cardiovascular collapse potentially resulting in death. Immediate emergency management is essential.

Which Tests are Conducted in the Allergy and Immunology Unit?

Avoiding allergens is the most effective and prioritized approach in the prevention of allergic reactions. Therefore, identifying the substances that trigger an exaggerated immune response in an individual is essential. Since many of the tests conducted for this purpose carry varying degrees of risk for inducing anaphylaxis, they must be performed under the supervision of experienced specialists. Sensitization observed in skin tests alone is not sufficient to confirm an allergy. A thorough evaluation by an expert, combined with the patient’s clinical history, is required to avoid false-positive outcomes.

The following clinical practices are commonly performed for diagnostic purposes in the allergy and immunology unit:

• Skin tests: Prick Test, Intradermal Test, Patch Test
• Specific IgE Testing in Blood
• Respiratory Function Tests
• Reversibility Tests
• Bronchial Provocation Tests
• Drug/Food Provocation (Loading) Tests

The most frequently used methods in the treatment of patients in the allergy and immunology unit include:

• Pharmacological Treatment
• Immunotherapy and Desensitization Treatments
• Biological Agent Therapies

Treatment Methods in the Allergy and Immunology Unit

The Allergy and Immunology medical unit is responsible for not only diagnosing diseases related to allergies and the immune system but also planning appropriate treatment methods. Once the specific allergen has been identified, the treatment approach is tailored accordingly.

The treatment methods applied can be listed as follows:

Pharmacological Treatment

This approach involves the use of various medications to suppress allergic reactions and alleviate symptoms. These medications are commonly used to reduce complaints such as nasal discharge, itching, coughing, and shortness of breath.

Immunotherapy

This treatment method targets known allergens. It begins with low doses and gradually increases exposure in a controlled manner over time. The treatment process may last several years, and regular medical supervision is essential.

Biological Agent Therapies

Used in moderate to severe allergic conditions when standard treatments fail to provide sufficient relief. These therapies involve medications that target specific components of the immune system to reduce inflammation effectively.

Frequently Asked Questions About Allergy and Immunology

How are allergies related to the immune system?

When individuals allergic to harmless substances such as pollen, mold, or dust come into contact with these allergens, their immune system begins to produce antibodies.
This triggers an exaggerated response in the body, leading to symptoms such as itching, nasal discharge, and wheezing.

What is the difference between an immunologist and an allergist?

An allergist plays a role in the diagnosis and treatment of allergic conditions that develop in the body, while an immunologist deals with and evaluates broader immune system disorders such as genetic abnormalities, autoimmune diseases, or immunodeficiencies.

Is allergy due to a weak immune system?

The most significant reason behind the development of allergies is an overactive immune response. Rather than being weak, the immune system reacts excessively, which leads to hypersensitivity and the onset of allergic conditions.

When should I see an immunologist?

If infections recur frequently, immune system problems emerge, or there is a persistent fever with no clear cause, it is advisable to consult an immunology specialist.

What are the seven autoimmune diseases?

Common autoimmune diseases include: rheumatoid arthritis, systemic lupus erythematosus (SLE), Hashimoto’s thyroiditis, type 1 diabetes, psoriasis, multiple sclerosis (MS), and celiac disease.