Allergy and Immunology
Conditions Treated

Allergic and Immunologic Conditions

The Division of Allergy and Immunology at Cincinnati Children’s offers consultation, treatment and diagnostic testing for children with many allergic and immunologic disorders, including asthma, atopic dermatitis (aka eczema), hay fever (allergic rhinitis), drug allergy, eosinophilic disorders, food allergy, primary immune deficiency and other conditions.

Commonly Treated Conditions

Asthma is a chronic (lifelong) disease that can cause changes in the lung such as swelling of the lining in the airways, tightening of the muscles around the airways (a spasm) and extra mucus in the airways. These changes can sometimes make breathing difficult. Even if someone with asthma does not have symptoms, there is almost always some inflammation or swelling in the airways. Certain triggers can cause this inflammation to increase, which may cause asthma symptoms to worsen. These triggers are different from person to person. Although asthma is a chronic disease, anyone with asthma can have an acute (sudden) attack of symptoms. Asthma can be controlled with medications. 

Asthma patient using an inhaler.

Atopic dermatitis, also known as eczema, is a long-term inflammatory skin condition that typically appears during the first few years of life. People with eczema commonly have patches of dry and thickened skin or skin that is red and itchy. Eczema may be caused by an allergic reaction to foods and/or environmental allergens. For those with food allergies, avoiding the reaction-causing food may improve eczema. Other treatments include keeping the skin moist with petroleum-based skin products (Vaseline, Aquaphor or Eucerin), administering skin cream medicines or taking oral medication. Eczema is a chronic disease but is usually most severe during the first few years of life.

An allergic reaction to a medicine can include symptoms such as a rash (like hives) or red, itchy skin; stuffy or itchy nose, sneezing or itchy and teary eyes; or vomiting, stomach cramps or diarrhea; or swelling of the lips, nose, face, hands or feet. Severe drug allergies can sometimes result in a life-threatening reaction called anaphylaxis, which may have symptoms such as hoarseness, throat tightness or lump in the throat; wheezing, chest tightness or trouble breathing; or tingling in the hands or feet, lips or scalp. Any time a person takes a medicine, they can have a reaction. This can happen when taking a medicine by mouth or when getting a medicine through a shot or an IV. Sometimes the reaction is a side effect of the medicine or a symptom of the illness, and sometimes it can be an allergic reaction to the medicine.

The best way to decide whether it was an allergic reaction to a medicine is to have allergy testing for the medicine taken before the reaction. Evaluating allergic reactions to medicines can usually be done during an outpatient clinic visit. Sometimes, an admission to the hospital for careful monitoring is needed. For people with drug allergies, their immune systems can over-react to the structure of a certain medicine or family of medicines. For instance, amoxicillin is a commonly prescribed antibiotic that is part of the penicillin family of antibiotics. Allergy testing can help people know whether they are allergic to only one medicine or the entire family of medicines. Knowing which medications a person is allergic to helps that person know which medicines to avoid and also which medicines he or she can safely take. Which medicines trigger reactions and which are safe for use may be different between people. Knowing for each person through drug allergy testing will help he or she receive the best possible care.

Learn more about the Drug Allergy Program and Penicillin Allergy Testing Services (PATS)

Eosinophilic disorders occur when eosinophils, a type of white blood cell, are found in above-normal amounts in various parts of the body. When the body produces too many eosinophils, they can cause chronic inflammation, resulting in tissue damage and a range of clinical symptoms. These rare diseases are diagnosed according to where the elevated levels of eosinophils are found: eosinophilic colitis (large intestine), eosinophilic enteritis (small intestine), eosinophilic esophagitis (esophagus), eosinophilic gastritis (stomach) and hypereosinophilic syndrome (blood and any organ). The most common of these rare disorders is eosinophilic esophagitis, which has symptoms resembling gastroesophageal reflux disease including trouble swallowing, vomiting, abdominal pain and food getting stuck in the esophagus. Treatments for eosinophilic disorders include changes in diet and prescription medications, and Cincinnati Children’s is one of very few centers with expertise in diagnosing, treating and researching these disorders in children and adults.

Visit the Eosinophilia Clinic or Cincinnati Center for Eosinophilic Disorders.

For people with food allergies, their immune systems overact to the proteins of a certain food or foods, resulting in an allergic reaction that can include symptoms such as:

  • a rash or red, itchy skin.
  • stuffy or itchy nose.
  • sneezing or itchy and teary eyes.
  • vomiting, stomach cramps or diarrhea.
  • angioedema or swelling.

Severe food allergies can sometimes result in a life-threatening reaction called anaphylaxis, which may have symptoms such as hoarseness, throat tightness or lump in the throat; wheezing, chest tightness or trouble breathing; or tingling in the hands or feet, lips or scalp.

Many foods can cause food allergies; however, the most common are:

  • cow’s milk.
  • eggs.
  • peanuts.
  • wheat.
  • soy.
  • fish.
  • shellfish.
  • tree nuts (almonds, walnuts, hazelnuts, Brazil nuts, pecans).

Management of food allergy typically includes elimination of the reaction-causing food from the diet, other avoidance precautions to limit exposure to the reaction-causing food and a plan of action in case of accidental exposure. More recently, exciting clinical trials have shown the value of food tolerance protocols in the treatment of food allergy.

Learn more about the Food Allergy Program

People with primary immune deficiencies have a reduced ability to resist or rid themselves of infectious diseases because their immune system is either absent or only partially functional due to a hereditary or genetic defect. This deficiency can be in one or more of the parts of the body’s immune system such as in primary T cell deficiency (combined immune deficiency, DiGeorge syndrome, severe combined immune deficiency (SCID), Wiskott-Aldrich syndrome), B cell deficiency (common variable immunodeficiency, hyper IgM syndrome, IgA deficiency, specific antibody deficiency, X-linked agammaglobulinemia), or granulocyte deficiency (Chediak Higashi syndrome, chronic granulomatous disease (CGD), hyper IgE syndrome, leukocyte adhesion defect (LAD)). Our division offers treatment and immunologic evaluation of suspected immunodeficiency, including detailed evaluation of cellular immunity (lymphocyte phenotyping, enumeration and activation markers; T cell mitogen and antigen responses; cytotoxic T lymphocyte function; natural killer cell function), antibody function (antibody levels − IgG, IgA, IgM, IgE, IgG subclasses; specific antibody responses to vaccines or pathogens; complement levels and function) and granulocyte morphology and function (adhesion, phagocytosis, killing; respiratory burst).

Learn more about our Transition and Adult Immunodeficiency Program.

A patient talks with a nurse.
Teaching tools (e.g. allergy skin-test teaching doll) can familiarize children with procedures. 

Programs and Clinics

 Our division has specialized clinics and closely collaborates with other centers and divisions within Cincinnati Children’s. Read More