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Allergy and Immunology

Allergies occur when your body reacts to certain outside substances that trigger a reaction, or overreaction, from your immune system. Triggers can come from certain food, animals, or seasonal allergens including pollen, grass and molds. Allergy and immunology services involve the management of disorders related to the immune system. These conditions range from the common to the rare, affecting all ages and organ systems.

Respiratory Conditions

Respiratory conditions from allergies include Rhinitis, Chronic Sinusitis and Asthma. The doctors and staff at Dignity Health are committed to providing effective relief from allergy-induced respiratory conditions.

If you sneeze a lot, if your nose is often runny or stuffy, or if your eyes, mouth or skin often feels itchy, you may have allergic rhinitis, a condition that affects 40 million to 60 million Americans. Or you may have nonallergic rhinitis, which involves similar symptoms, but with no apparent allergic cause. 

People with allergic rhinitis generally experience symptoms after breathing in an allergy-causing substance such as pollen or dust. Triggers of nonallergic rhinitis symptoms vary and can include certain odors or irritants in the air, changes in the weather, some medications, certain foods, and chronic health conditions.

Allergic rhinitis is commonly known as hay fever, which is misleading since it neither requires exposure to hay nor produces a fever.

With sinusitis, the tissues inside your sinuses become inflamed and blocked due to swelling and mucus buildup. Sinusitis is considered chronic after at least 12 weeks of symptoms. Chronic sinusitis can make it especially hard to breathe due to long-term blockage and inflammation. 

Other common symptoms of chronic sinusitis include:
Trouble smelling or tasting food and drinks
Yellow or green-colored mucus dripping from your nose
Dry or hardened mucus blocking your nasal passages
Mucus leaking down the back of your throat 
Tenderness or discomfort in your face, especially in the area of your eyes, forehead, and cheeks
Headaches due to sinus pressure
Pain in your ears

Some home treatments can help relieve symptoms. But you may need medication and long-term treatment to keep the symptoms from coming back. In rare cases, your doctor may recommend surgery if home treatments and medication don’t help.

Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs. With asthma, the airways are always inflamed, and they become even more swollen and the muscles around the airways can tighten when something triggers symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.

People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place, you will be able to manage your condition and your quality of life will improve.

Dermatological (Skin-Related) Conditions

Dermatological conditions from allergies include Chronic Uticaria, Eczema and Angioedema. The allergy and immunology department at Dignity Health uses the latest technology and findings to develop effective treatment programs for these conditions.

Urticaria, also known as hives, are red, itchy welts that result from a skin reaction. The welts vary in size and appear and fade repeatedly as the reaction runs its course. Usually, they go away quickly. However, the condition is considered chronic if the welts appear for more than six weeks and recur frequently over months or years. 

Chronic hives can be very uncomfortable and interfere with sleep and daily activities. They’re often caused by an allergic reaction to a food or drug, however the exact cause of chronic hives is not clear.The immune system seems to play a role. Some people get chronic hives at the same time that they get other problems like thyroid disease, hormonal problems, or cancer.

Eczema is a term for a group of medical conditions that cause the skin to become inflamed or irritated. Affected areas usually appear very dry, thickened, or scaly. No matter which part of the skin is affected, eczema is almost always itchy. Sometimes the itching will start before the rash appears, but when it does, the rash most commonly appears on the face, back of the knees, wrists, hands, or feet. It may also affect other areas as well. In fair-skinned people, these areas may initially appear reddish and then turn brown. Among darker-skinned people, eczema can affect pigmentation, making the affected area lighter or darker.

The exact cause of eczema is unknown, but it's thought to be linked to an overactive response by the body's immune system to an irritant.

Angioedema is the rapid swelling and accumulation of fluid beneath the skin. It tends to affect areas with loose areas of tissue, especially the face and throat, as well as the limbs and genitals. Allergic angioedema is the most common type, and it usually affects those with an allergy to:
A food
A medication
Animal dander
Angioedema is similar to urticaria, or hives. However, urticaria affects only the top layer of skin. Angioedema affects the deeper layers. It is not uncommon to have both urticaria and angioedema at the same time.

Take Control of Your Asthma with Propeller

For patients who suffer from asthma, Dignity Health Medical Foundation recommends a free benefit for our patients called Propeller (no link). Propeller is an asthma solution clinically proven to help people live more asthma-free days.  For more information, please call our office at 530.668.2600, or speak with your doctor on your next visit and join many others improving their asthma. 

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Systemic Conditions

Allergy-related systemic conditions include anaphylaxis, eosinophilic disorders and immunodeficiency disorders. Dignity Health staff is committed to providing effective and rapid relief to these conditions. 

Anaphylaxis is a severe, potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you're allergic to, such as peanuts or bee stings.

Anaphylaxis causes your immune system to release a flood of chemicals that can cause you to go into shock — your blood pressure drops suddenly and your airways narrow, blocking breathing. Signs and symptoms include:
Rapid, weak pulse
Skin rash
Nausea and vomiting
Common triggers include certain foods, some medications, insect venom and latex. Anaphylaxis requires an injection of epinephrine and a follow-up trip to an emergency room. If you don't have epinephrine, you need to go to an emergency room immediately. If anaphylaxis isn't treated right away, it can be fatal.

Eosinophils are a normal cellular component of the blood and of certain tissues. When the body wants to attack a substance, such as an allergy-triggering food or airborne allergen, eosinophils respond by moving into the area and releasing a variety of toxins. However, when the body produces too many eosinophils, they can cause chronic inflammation resulting in tissue damage. Eosinophilic disorders are diagnosed according to the part of the body where the levels of eosinophils are elevated.

Immunodeficiency disorders prevent your body from fighting infections and diseases. This type of disorder makes it easier for you to catch viruses and bacterial infections. Immunodeficiency disorders are either congenital (one you were born with) or acquired (one you get later in life). Most cases of immunodeficiency are acquired and are due to factors our bodies encounter such as:
HIV infection
Extremes of age

Comprehensive Allergy Services

The doctors and staff at the Dignity Health Allergy and Immunology department strive to treat the whole symptom and have effective outcomes for all allergy and immunology issues.  

Seasonal allergy symptoms aren't only a bother, but as allergy sufferers can attest, they can affect everyday activities. During the Sacramento Valley allergy season, watery eyes, sneezing, nasal congestion and wheezing can affect your ability to sleep, work and perform outdoor activities. Allergies can even lead to severe symptoms such as asthma.
Prepare yourself for the Sacramento Valley allergy season by opting for allergy testing at Dignity Health Medical Foundation — Woodland and Davis. The most common technique is a skin prick test. Also called a puncture or scratch test, it checks for immediate allergic reactions to as many as 40 different substances at once. This test is usually done to identify allergies to pollen, mold, pet dander, dust mites and foods. In adults, the test is usually done on the forearm. Children may be tested on the upper back. Typically, this test takes about 20 to 40 minutes. 

Allergy Immunotherapy 
Immunotherapy is a preventive treatment for allergic reactions to substances such as grass pollens, house dust mites and bee venom. Immunotherapy involves giving gradually increasing doses of the substance, or allergen, to which the person is allergic. The incremental increases of the allergen cause the immune system to become less sensitive to the substance, probably by causing production of a "blocking" antibody, which reduces the symptoms of allergy when the substance is encountered in the future.

Allergy shots are the most commonly used and most effective form of allergy immunotherapy. This is the only treatment available that actually changes the immune system, making it possible to prevent the development of new allergies and asthma.

Sublingual immunotherapy is an alternative way to treat allergies without injections. An allergist gives a patient small tablet or drop doses of an allergen under the tongue to boost tolerance to the substance and reduce symptoms. Unlike shots, tablets and drops only treat one type of allergen and do not prevent the development of new allergies and asthma.

Contact dermatitis is an itchy, blistering skin rash typically caused by the direct contact of a substance with the skin. The rash typically has small blisters containing clear fluid, but can swell, crust, ooze or peel in other cases. 

The diagnosis is made with a patch test, which involves the placement of various chemicals on the back for approximately 48 hours. (It is not the same as allergy testing.) This typically is done with a paper tape system, such as the TRUE test. The TRUE test is the only FDA-approved test for contact dermatitis in the United States.

We evaluate drug allergies (adverse drug reactions) and conduct drug challenges and drug desensitizations to help patients tolerate many different drugs.

By providing careful evaluation of many different classes of drugs, we aim to ensure patients can safely complete therapy with the most effective medication to treat their condition. We most commonly evaluate patients who have possible adverse reactions to:

Drug Challenge
We will perform a drug challenge under close monitoring and supervision if your evaluation suggests you are unlikely to experience an allergic reaction to the medication. During the challenge, we will give you one to two doses of the medication in increasing amounts—carefully monitoring you for any reactions along the way—to ensure you can tolerate the full intended treatment dose.

Drug Desensitization
If your evaluation suggests you are at significant risk for suffering an allergic reaction to the medication, we will perform a drug desensitization. This involves taking escalating doses of the medication at a very slow rate of progression until reaching the optimal dose. Safety is always our first priority. Our team's experience helps us to anticipate possible complications and address them quickly and successfully.

Your allergist may recommend food allergy tests. In an allergy skin test, a very small drop of a liquid food extract, one for each food, is placed on the skin. The skin is then lightly pricked. This is safe and generally not painful. Within 15 to 20 minutes, a raised bump with redness around it, similar to a mosquito bite, may appear. It shows that you are probably allergic to that food and you probably need food allergy treatment.

Sometimes, an allergy blood test may be used. If done right, skin tests or blood tests are reliable and can rule in or out food allergy.

Food Challenge
An oral food challenge (OFC) is a supervised process in which a food is eaten slowly, in gradually increasing amounts, under medical supervision. OFCs are usually done when a careful medical history and allergy tests, such as skin and blood tests, are inconclusive. The OFC is a more definitive test because it will show whether the food ingested produces no symptoms or triggers a reaction.

A physical examination and vital signs are done before starting and every 15-30 during the test. The OFC starts with a small serving of the food and after a consistent interval of time, if no symptoms are present, a slightly larger amount is eaten.

Before each subsequent dose, careful evaluation is performed to look for any symptoms. If symptoms occur, and the medical personnel judge that a reaction is happening, the feeding is stopped and medications are given as needed. Otherwise, the feeding continues until, typically, a meal sized portion is eaten.

The benefits of food challenges include the nutritional and social benefits of being able to expand the diet if the food is successfully eaten without symptoms. However, even if the food triggered a reaction, the benefit is knowing that the food is truly a problem and needs to be avoided to maintain health.

Food Allergy Desensitization
Until recently, the only treatment for food allergic patients has been strict avoidance of these foods and carrying injections of epinephrine in the event of an accidental ingestion. Today there is exciting and effective treatment available for the majority of peanut, tree nut, milk and egg allergic patients. It is called oral immunotherapy, where patients are fed small incremental amounts of food proteins to which they are allergic. In our carefully controlled clinical setting we have safely desensitized children and adults who are allergic to these foods. As a result of this new treatment, if allergic patients are accidentally exposed to these foods, they should not experience an allergic reaction. Many can eventually consume as much of these foods as they would like while on treatment.

Quality Care is Our Commitment

At Dignity Health Medical Foundation—Woodland and Davis, we are committed to providing high quality allergy and immunology services. Our main focus is to make a positive difference in the health status and lives of everyone in our community, with special concern for those of all ages who have allergies.

Meet Our Team

Call 530.668.2600 to schedule an appointment. Or use our Find a Doctor tool to reach an allergist/immunologist near you.