Dr Liam Beiglari Clinical immunologist
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Understanding allergies

Liam Beiglari · · 2 min read

I assess food and insect venom allergies, hay fever, suspected drug reactions and anaphylaxis. I also help with related conditions such as chronic hives and eczema. Assessment starts with your history. This is arguably the most important part of an allergy assessment. Review of previous medical records (such as discharge summaries) is also often required if you have had any allergy assessments or emergency department visits before. Additional investigations, like skin testing and blood tests, may be required and can be very helpful.

What is an allergy?

When the immune system reacts to a substance that most people tolerate we call this allergy. These allergens can be common in the environment (e.g. pollen, dust mite, some foods) or less common and only encountered under specific conditions (e.g. certain medications).

Allergies are common. ASCIA’s patient information reports that allergic rhinitis (hay fever) affects around 18% of people in Australia and New Zealand.

What happens in an allergy assessment?

I will take a detailed history and examine you. Skin-prick testing or blood tests for specific IgE antibodies may help answer a particular clinical question. I will consider these results alongside your symptoms. The tests often provide support for or against the diagnosis that we are looking for. However, a positive test by itself does not establish that an allergen is causing your reactions.

Common reasons to see me

  • Allergic rhinoconjunctivitis: hay fever and allergic eye symptoms.
  • Food allergy.
  • Chronic spontaneous urticaria: recurring hives that can be troublesome and affect daily life. This is usually not caused by an external allergy.
  • Anaphylaxis assessment, management plans and adrenaline autoinjector training.
  • Suspected drug allergy and adverse drug reactions.
  • Bee and wasp venom allergy, with venom immunotherapy where indicated.
  • Eczema, also called atopic dermatitis.

Not every condition assessed in an allergy clinic is caused by an allergy. This is one reason a careful history matters more than a broad panel of tests.

Penicillin allergy

In order to assess penicillin allergy, I will ask you some questions about the events that led to you needing assessment. Skin testing or a supervised oral challenge may be appropriate in some cases.

Please note
I am not able to assess allergy to anaesthetic medications or selected complex drug allergy presentations. If you have been referred for this and are unsure if I can be of assistance please contact the rooms for advice.

Preparing for skin-prick testing

If skin-prick testing is planned you will need to avoid oral and intranasal antihistamines for four days beforehand. You can continue your asthma puffers. If you are unsure about any other medicines, please check with my rooms before your appointment.

Antihistamines block the action of histamine at the histamine receptor. This is a beneficial effect of the medications and is the reason we use them to treat conditions where histamine release is the cause of symptoms. However, skin testing requires an appropriate histamine response in order to work properly. This is why we ask you to stop oral antihistamines 4 days before the appointment.

Useful reading & support

Your first appointment

Your first appointment takes approximately 45 minutes. I will take a detailed history, perform relevant testing on the day where appropriate and possible, and explain the findings and a management plan. Please bring relevant blood tests, other investigations and supporting documents.

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This is general information to support, rather than replace, advice about your individual care.

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