Frequently Asked Questions

What are Allergies?

Allergies occur when the immune system reacts against usually harmless substances in the environment, types of food or drugs (“allergens”). The immune system is extremely complex and so there are many opportunities for things to go wrong. When the immune system reacts against an allergen, an exaggerated, damaging immune response occurs.

Allergic diseases are common and are increasing in prevalence, complexity and severity. They include food, insect and drug allergies, and allergic rhinitis (hay fever). Asthma and eczema may be more severe in patients with allergy and are immune-mediated conditions. The most severe type of allergic reaction is known as anaphylaxis, which is potentially life threatening.

Please note that food allergies are different from food intolerances. Food intolerances are symptoms caused by specific foods but they are not due to an abnormal immune response to the food. Testing (blood tests and/or skin prick testing) can be required to determine whether a food allergy is present but sometimes it is clear cut from the history and testing is not required.

Urticaria (hives) and angioedema are conditions of the immune system commonly confused with allergy and can present with somewhat similar symptoms. There can be environmental and drug triggers for these conditions, however the treatment of them is quite different to the treatment of allergy. Therefore, a proper diagnosis is important.

What are Immunodeficiencies?

Immunodeficiencies are serious, potentially life-threatening conditions that lead to recurrent infections and, in some cases, cancers if untreated. Primary immunodeficiencies are often due to genetic problems affecting the immune system. They are usually diagnosed in children, who develop very frequent and unusual infections. In adults, primary immunodeficiency may be milder and can therefore be more difficult to diagnose. It is usually detected due to frequent, severe or unusual infections as well. Immunodeficiency may occur as a consequence of treatment for other medical conditions (such as after chemotherapy) in which case it is called secondary immunodeficiency. It will also usually be diagnosed following multiple recurrent infections, which are often unusual, but it may be detected on screening tests in some cases.

What is Autoimmune disease?

An autoimmune disease is a condition in which your immune system mistakenly attacks your body. The immune system normally guards against foreign organisms such as bacteria and viruses. The immune system also has an important role in detecting abnormalities in the body’s cells which if unchecked can lead to cancers. There are many different ways in which the immune system protects us from infection and cancers.

Normally, the immune system can tell the difference between foreign cells and your own cells. In autoimmune diseases, the immune system mistakes proteins found in specific cells in part of your body — like your joints or skin — as foreign. It releases proteins called autoantibodies that attack healthy cells. This can establish an abnormal immune response with recruitment of many other types of immune cells, leading to tissue destruction.

Some autoimmune diseases target only one organ. For example, Type 1 diabetes damages the pancreas. Other diseases, like lupus, can affect many different types of tissue throughout the whole body.

Any tissue of the body can be affected in autoimmune disease, therefore many different symptoms are possible. Autoimmune diseases are frequently treated with medications that suppress the immune system (immunosuppressants) or change the immune system to be less inflammatory (immunomodulators).

There are many autoimmune diseases which are not primarily treated by immunologists, but immunologists may be consulted if there is a lack of response to standard treatments. Many autoimmune conditions can be treated by dermatologists, endocrinologists, neurologists, rheumatologists and ophthalmologists for instance without needing to see an immunologist. However, there are some conditions which are frequently primarily treated by an immunologist especially if they involve more than one system of the body (e.g. skin, nervous system, gut).

What is Lupus?

Lupus or Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect any tissue in the body, but confusingly can also be limited for instance just affecting the kidneys.

Despite many years of research, the exact cause of lupus is still not known. It is likely that there is an underlying genetic risk that makes people more likely to develop autoimmunity. Then most likely there is an environmental or infectious trigger, or a combination of triggers, that stimulates the immune system to start reacting to proteins that should be recognized as self.

However, some people with lupus may have few or none of these symptoms, and there are many other causes for some of these symptoms as well.

What is Vasculitis?

Vasculitis is a general term for a group of uncommon diseases that feature inflammation of the blood vessels. Vasculitis is characterized by inflammation in and damage to the walls of blood vessels.

Each of the vasculitis diseases is defined by certain patterns of distribution of blood vessel involvement, particular organ involvement, and laboratory test abnormalities. As blood vessels are found in all parts of the body, many different systems or organs can be affected.

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