Pediatric Allergy & Immunology

The Division of Allergy, Immunology, and Rheumatology cares for adult and pediatric patients with disorders of the immune system. Our patients have an unusual susceptibility to allergies and asthma, autoimmunity, autoinflammation, or severe, recurrent or opportunistic infections. We offer the most advanced diagnostics and treatments in the country. Our faculty members include leaders in the field and provide excellent clinical care and conduct cutting-edge research. We operate two ACGME-certified programs to train future leaders in the fields of Allergy and Immunology, and Pediatric Rheumatology.

The program has a long and cherished history beginning in 1969 when Dr. E. Richard Stiehm served as the first chief of the division. Faculty in the division have discovered the mechanistic causes of numerous immune diseases in children, developed uses of immune globulin in the prevention and treatment of infections, and pioneered methods for bone marrow and cord-blood transplants. In the early years of HIV, Immunology division faculty were instrumental in recognizing AIDS in children and in leading efforts to prevent maternal transmission of HIV to fetuses.

Allergy Program

Our allergy clinic has a focus on food allergy, allergic rhinitis and conjunctivitis, asthma, and drug allergy. Additionally, we care for children with asthma and other respiratory disorders. State-of-the-art skin testing and blood tests are performed in the clinic to provide answers about allergic sensitization. Food challenges are performed to definitively assess the risk of immediate-type food allergies.

Delayed-type gastrointestinal diseases (including Food Protein Induced Enterocolitis Syndrome, celiac disease, and eosinophilic gastroenteritis) are followed with our colleagues from Gastroenterology. Spirometry testing and allergy testing are used to facilitate the management of asthma with our colleagues from the Pulmonary clinic.

Our clinic has the most sophisticated reagents for assessing drug allergies and can provide options for treatment, including desensitization. These efforts improve the quality and stewardship of antibiotics used across the hospital system.

Immunology Program

Our immunology clinic focuses on primary immunodeficiency disease, also called genetic immune diseases. These “mystery” diseases confer a susceptibility to severe, recurrent or opportunistic infections, autoimmunity, and autoinflammation. We care for antibody deficiencies such as Common Variable Immune Deficiency (CVID) and more serious defects of the adaptive immune system, including T cell defects such as Combined Immunodeficiency (CID) and severe combined immune deficiency (SCID). We are recognized by the state as a major referral center for Southern California for management of newborn babies who screen positive for SCID.

We employ whole exome and genome sequencing as well as cutting-edge genetic validation to diagnose novel or rare immune diseases. Treatments include immunoglobulin replacement infusions (subcutaneous or intravenous), immunomodulatory medicines, anti-inflammatory medicines, and advanced cellular therapies, including hematopoietic stem cell transplantation and gene therapy.

Diagnostic Services include:

• Allergy skin testing (prick testing, patch testing)
• Measurements of lung function (spirometry)
• Specific IgE testing (RAST, Immunocap, ISAC)
• Imaging: chest & sinus X-rays and CT scans
• Food and drug challenges
• Nutritional evaluation of patients with food allergies
• Comprehensive evaluation of the immune function
• In-clinic ultrasound of the joints to monitor arthritis
• Genetic testing for immune diseases
• T cell testing
• Vaccine challenges
• Innate immune function testing

Treatments include:

• Immunotherapy (Allergy shots)
• Immunoglobulin treatment (IVIG)
• Immunomodulation
• Ultrasound-guided joint injections
• Drug desensitization
• Disease-specific management
• Allergen elimination diet