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Diagnosis & Treatment

An accurate diagnosis is the first step in managing childhood allergy and immunology problems. Our specialists provide complete evaluations that can include:

  • Allergen skin testing
  • Allergen patch testing
  • Blood testing
  • Food challenges
  • Desensitization procedures
  • Exercise challenges
  • Exhaled nitric oxide measurements
  • Immune function testing
  • Lung function testing

Following a comprehensive evaluation, our team will create an individualized treatment plan in collaboration with you, your child, and your child’s pediatrician. Such a plan might include:

  • Avoidance/Environmental Modification – A primary approach to preventing allergic reactions is to avoid the allergens that trigger symptoms. Once these allergens are identified, we will review and discuss the most effective strategies to avoid them.

  • Medications – When symptoms warrant drug treatment, there are several medications that are effective in treating allergic disease:
    • Antihistamines – Available both over the counter and by prescription, these drugs block the action of histamine, which is a chemical released by the body’s immune cells during an allergic response.
    • Corticosteroids – Available only by prescription, corticosteroids work by decreasing the inflammation caused by allergic reactions. Topical steroid formulations are available for the treatment of allergic conditions of the nose and skin, and inhaled steroids may be indicated for asthma (see below). Corticosteroids are occasionally given orally for the management of severe allergic or asthmatic reactions.
    • Leukotriene modifiers – These medications block the production or effects of leukotrienes, chemicals involved in causing the inflammation associated with allergic reactions (particularly asthma and allergic nasal and eye-related symptoms).
    • Asthma medications – These include quick-relief and controller medications. Quick-relief medications, such as albuterol, are used to treat sudden onset symptoms such as wheezing and shortness of breath. Controller medications are used to calm the airways, decrease inflammation, provide better asthma control, and reduce the need for quick-relief medications. Controller medications include leukotriene antagonists and inhaled steroids.
    • Anti-Immunoglobulin E (anti-IgE) (omalizumab) – This is a relatively new medication that attaches to the allergy antibody (IgE) in the bloodstream and prevents it from reaching cells in the body involved in the allergic response. It is given as a shot once every 2 to 4 weeks and reserved for the treatment of moderate to severe asthma triggered by allergic reactions.

  • Immunotherapy (allergy shots) – In patients whose respiratory symptoms are known to be caused by allergies and the allergens are clearly identified, sometimes diluted extracts of the allergens are formulated and injected into the patient in gradually increasing amounts over several months to induce tolerance or desensitization. The total treatment course is 3-5 years. This is the most effective way to actually decrease your tendency toward allergy, not only your symptoms of allergy.

  • Oral Desensitization Therapy – This is a procedure usually done in the hospital to decrease allergy to certain medications, such as aspirin and antibiotics, when these medications are absolutely essential for your health.

 

The Barbara Bush Children's Hospital is a department of Maine Medical Center