Allergy and Immunology

  • Clinical Training

    All fellows rotate as consultants during the clinical training year. This experience consists of allergy and immunology consultations in both the pediatric (Cincinnati Children’s) and internal medicine institutions (University of Cincinnati [UC] Medical Center and Cincinnati Veterans Affairs [VA] Medical Center). The three hospitals are within a comfortable walking distance, 1-2 blocks from each other. The Allergy / Immunology fellows are responsible for the direct supervision of the residents caring for the allergy and immunology patients. The diagnoses seen in consultations include immunodeficiencies (mostly congenital), acute asthma exacerbations and status asthmaticus, food allergy and anaphylaxis, multiple antibiotic allergies (particularly in patients with cystic fibrosis, requiring drug testing and desensitization), other medication allergy, eosinophilic disorders and vasculitis syndromes. On average, the Allergy / Immunology fellows see approximately 7 inpatient consultations per week while on clinical rotation.

    Outpatient Allergy / Immunology Services

    The pediatric Allergy / Immunology clinic meets four times a week at Cincinnati Children’s, in addition to a weekly, whole-day immunodeficiency clinic. The patients seen in the outpatient clinics are seen in consultation requested by the primary care physicians in pediatrics, internal medicine or family practice on the Cincinnati Children's and UC Medical Center staff, from community allergists and from national and international referrals. Consultations are also requested by other sub-specialists, e.g. pulmonology, infectious disease, dermatology and surgical colleagues. 

    There are three major outpatient clinics on the Internal Medicine track. These are located at the UC Medical CenterCincinnati VA Medical Center and in an off-campus private practice site (Bernstein Allergy Group) staffed by one of the faculty-attending physicians (David I. Bernstein, MD, Jonathan Bernstein, MD, Christopher McKnight, MD). 

    All Allergy / Immunology fellows rotate through the immunodeficiency clinic and receive cross-training in adult and pediatric allergy. Several centers of excellence constitute our clinical programs:

  • Clinical Centers of Excellence

    Show All

    Allergy Program

    In the allergy clinics, the fellows evaluate ample numbers of patients of all ages and who have a spectrum of allergic disorders including mild to severe asthma, allergic rhinitis, occupational asthma, urticaria, drug and venom hypersensitivity, food allergy, eczema and eosinophilic disorders. The allergy medical history and clinical exam are recorded on standardized forms that capture all familial and environmental predisposing factors.

    Center for Eosinophilic Disorders

    Over the last decade, an unprecedented number of allergic patients have presented to Cincinnati Children’s with recurrent gastrointestinal complaints and are eventually diagnosed with an eosinophilic gastrointestinal disorder (EGID). This coincides with a flurry of articles published on these diseases. Accordingly, a multi-disciplinary team of health care providers (including allergists, gastroenterologists, pathologists, research scientists, biostatisticians, epidemiologists and nutritionists) collaborated to found the Cincinnati Center for Eosinophilic Disorders (CCED). By working together in synergy, this team aims to understand the pathogenesis and best treatment strategy for EGID.

    The CCED currently sees 3 to 5 new patients per week and has become an international leader in caring for these patients and researching these diseases. Thus, the CCED receives a growing number of domestic and international patients. In fact, the CCED has not only become a regional referral center, but also a center where patients are being referred to from all over the world. The CCED has seen patients from Canada, Australia, Europe, Israel and China, among other countries. Accordingly, the CCED receives daily inquiries from patients that are interested in coming to Cincinnati Children's for evaluation and treatment of their chronic medical problems. Several families have even moved to the region because of the quality care that the CCED provides.

    Diagnostic Immunology Laboratory

    All Allergy / Immunology fellows on the clinical service rotate in a diagnostic immunology laboratory located at either Cincinnati Children's or UC Medical Center, where they receive instruction on methods and interpretation of cellular proliferation, flow cytometry and multiplex assays of cultures.

    Food Allergy Program

    The Allergy / Immunology fellows acquire unique exposure to IgE- and non-IgE-mediated adverse reactions to foods. Patients are referred to the Food Allergy Program from the regions surrounding the hospital and from around the country. The multidisciplinary team includes allergy / immunology, nutrition, nursing and education. Patients are accurately phenotyped using a standardized medical history and physical examination form. The clinic conducts a large number of oral food challenges, averaging 2-3 per week and thereby providing a unique experience for the fellows.

    Immunodeficiency Program

    The Immunodeficiency and Histiocytosis Program is directed by Alexandra (Lisa) H. Filipovich, MD. A large variety of national and international referrals to the clinics enhance the clinical experience of the trainees. In addition, the rarity and complexity of these disorders have led to novel research projects conducted by fellows. The diagnoses evaluated and followed by the fellows in the outpatient immunodeficiency clinics at Cincinnati Children's cover the entire spectrum of rare congenital immunodeficiencies, including several in which our center has developed unique expertise (e.g. hemophagocytic lymphohistiocytosis (HLH) and X-linked Lymphoproliferative (XLP) disorders).

    Occupational Allergy and Asthma Program

    Our faculty have established an Occupational Allergy and Asthma Program that is widely recognized for research in work-related allergies and lung disorders. David I. Bernstein, MD is a faculty member leading an NIH-funded, international study evaluating genetic susceptibility for occupational asthma caused by reactive chemicals (NIOSH/CDC grant, R01 OH008795). The faculty are also investigating the immunologic mechanisms of these disorders with funding from government and industry contracts. Allergy / Immunology fellows will have an opportunity to evaluate occupational disorders during adult rotations and may elect to participate in a variety of ongoing experimental and clinical research projects.