Description of specialty
The specialty of clinical allergy addresses the role of external factors (foods, drugs and environmental triggers) in the causation of medical conditions. The most common medical conditions requiring input from a clinical allergist are rhinitis, asthma, anaphylaxis, urticaria, suspected food allergy and adverse drug reactions. Allergy is not a disease: it is a mechanism which can cause a variety of symptoms in patients. Patients with allergic conditions often have multisystem problems, which may not fit comfortably into the traditional organ-based specialty model. Clinical allergists therefore need to be trained to deal with a broad range of conditions and be able to offer a holistic opinion to someone whose allergies affect several different parts of the body, eg asthma, rhinitis or eczema.
Central to an allergy consultation is a detailed history focusing on what the patient has experienced, as opposed to what they may have been told is the cause of their symptoms. While the patient’s perspective is important, they have often acquired an incorrect view on the likelihood that allergy is responsible for their symptoms. It is just as important to rule out allergic causes as it is to identify a culprit allergen.
Most adult allergy patients are young people of working age. While there is relatively little mortality from allergy there is considerable morbidity and adverse effect on quality of life. Accurate diagnosis and advice, coupled with optimal use of drugs and specific immunological therapies can be life-transforming.