Starship Paediatric Immunology and Allergy : Healthpoint

Starship Child Health, Central Auckland

Contact Details

General Enquiries:
(09) 3074949
Outpatient Appointments:
(09) 638 0400 or 0800 PATIENT 0800 728 436 or scheduling@adhb.govt.nz
Emergency Department:
Open 24 hours / 7 days, Phone (09) 307 4902
GP/External Specialist Help Desk:
(09) 3072800

Street Address

2 Park Road
Grafton
Auckland 1023

Postal Address

Starship Child Health
Private Bag 92 024
Auckland Mail Centre
Auckland 1142
New Zealand

Description

The Starship Paediatric Immunology and Allergy Service is a tertiary referral service that provides inpatient and outpatient services for children with allergies and disorders of the immune system.

The team includes doctors and a clinical nurse specialist, and works closely with other paediatric doctors both at Starship and throughout New Zealand. The service also provides outreach clinics at some regional centres as well as telehealth clinics.

Immunology and Immune Deficiency

The immune system provides defence against many types of infections. Children with primary immune deficiency have disorders where the immune system does not function properly, placing them at risk of recurrent infections and other immune problems. Many of these children will have multiple hospital admissions and will also be seen as outpatients. The service is involved in the care of immune deficient children from around New Zealand, in liaison with the child's local paediatrician.
Some children will require ongoing immunoglobulin replacement therapy either at home or in the Day Stay Unit.
All babies born in New Zealand will have Newborn Screening (NBS) performed, which includes testing for Severe Combined Immune Deficiency, the most severe form of primary immune deficiency. The immunology team works directly with the NBS team to identify and care for patients with abnormal screening tests - https://www.starship.org.nz/guidelines/severe-combined-immunodeficiency-scid/
Other immune disorders can present with problems in the regulation of the immune system and can affect multiple body systems. The immunology service works alongside other paediatric specialists and teams in the diagnosis and care of such patients.

Allergy

Allergy is extremely common and most children with allergy will be looked after by their general practitioner, sometimes with the assistance of a general paediatrician. Only a minority of children with allergy will need to be seen by the Starship Immunology and Allergy service.

Examples of allergy problems that may need to be seen by the Starship Immunology and Allergy service include very severe allergic reactions / anaphylaxis, complicated food allergy, severe insect sting reactions and drug allergy. Most allergy patients will be seen only in outpatients.
The service also sees patients with the following conditions:
Allergic rhinitis (hayfever) for consideration of environmental immunotherapy https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/allergic-rhinitis-or-hay-fever
Chronic urticaria (hives) when symptoms are frequent or recurrent, or related to particular triggers such as cold or exercise https://www.starship.org.nz/guidelines/urticaria/
Angioedema including hereditary angioedema https://www.allergy.org.au/patients/skin-allergy/angioedema
FPIES – food protein induced enterocolitis syndrome https://www.allergy.org.au/patients/food-other-adverse-reactions/food-protein-induced-enterocolitis-syndrome-fpies

Referral Expectations

The Starship Paediatric Immunology and Allergy service receives more referrals than it is possible to see. Many of these referrals will be forwarded to general paediatric services. Referrals from paediatricians or other specialists will always be accepted. Some referrals will be returned to the GP with advice if, from the details in the referral, an appointment is not needed.

The waiting time for an appointment depends on the nature of the referral. Referrals for possible immune deficiency will be seen urgently. Referrals for severe allergic reaction will generally be seen within 6 weeks, while referrals for less urgent allergy problems may wait longer to be seen.

At the clinic your child will be seen by a Consultant Immunologist or an Immunology Registrar (who will discuss each case with the consultant), and this may also be via a telehealth clinic over the phone or by video conferencing. The doctor will take a detailed history of symptoms and ask about previous illnesses and medications. The history is the crucial part of the consultation. There will be other questions about general health designed to add helpful information to diagnose what is causing your child's symptoms. The doctor will then examine your child. They will explain to you as they go the reasons for the examination and then what tests or treatments are coming. It is helpful to bring your child’s well child book to the appointment, particularly if there are concerns about growth or food allergy.

If relevant, the doctor may ask for skin tests to be performed, either on the first clinic appointment or at a subsequent appointment. Certain skin tests may take some time to perform (e.g. up to 2 hours for some antibiotic allergy tests).

Your child may be started on medications or asked to undergo further testing (e.g. blood tests) before being seen again in the clinic or may be discharged back to your GP for ongoing management. A letter will be sent to your GP (with a copy to the family) with treatment recommendations as well as the results of any tests that are undertaken.

Some patients will need other procedures arranged such as food or drug challenge, or venom immunotherapy. Wait times for these procedures vary considerably depending on clinical urgency.

Hours

Open Monday to Friday 8am - 5pm

Procedures / Treatments

Allergy skin prick tests

Specific IgE blood tests (sometimes called RAST)

Food challenge

Drug challenge

Venom immunotherapy

Intravenous and subcutaneous immunoglobulin replacement in immunodeficiency

Other

www.allergy.org.au

Website of the Australasian Society of Clinical Immunology and Allergy. Links to:

anaphylaxis resources including action plans and EpiPen teaching resources
patient information on a variety of allergic conditions (food allergy, allergy prevention, dust mite avoidance etc)
eczema management information (including on "finger tip units" to guide on use of topical steroids).

www.idfnz.org.nz/

Website of the Immune Deficiencies Foundation of New Zealand, a community support organisation for children and families affected by immune deficiency.

http://www.allergy.org.nz/

Website of Allergy New Zealand, a community support organisation for children and families affected by allergy. Allergy NZ have many useful resources about specific food allergy, education of preschools and schools, and a cook book produced with food allergies in mind.

https://preventallergies.org.au/

Australian site with practical advice for families about allergy prevention strategies

https://250k.org.au/

Resource specifically for teens and young adults with food allergy

Website

www.adhb.health.nz/

https://healthpoint.co.nz/public/allergy-and-immunology/starship-paediatric-immunology-and-allergy/