The Clinical Immunology Department operates an outpatient clinical service twice a week and a five-day ambulatory care service in our Immunology Day Ward.
The clinical team see and treat patients with a wide range of conditions including immunodeficiency, vasculitis, coeliac disease, allergies and other autoimmune disorders.
We offer a dedicated immunology service comprising of outpatient assessment, day ward evaluation and treatment and consultation for inpatients.
We provide specialist services in the following areas:
We also provide an in-patient consult service and, as a pathology specialty, have roles in the INAB accredited Diagnostic Immunology Laboratory Service including; result validation, communication and quality control.
Primary immunodeficiency and vasculitis are the priority clinical areas of this department. Recent years have seen huge increases in referrals for allergic disease. We continue to advocate for resources to meet this area of overwhelming demand.
The Immunology Department is actively involved in research and education and regularly collaborates in research published in international peer-reviewed journals.
Appointments for the Immunology Clinical Service are made by the Immunology Department on receipt of a referral letter from the patient’s GP or referring doctor. Referral letters are evaluated by the consultant and appointments are offered to patients, if clinically appropriate.
The wait for a routine clinical immunology appointment may be up to 24 months. Urgent referrals are seen sooner. There is no private immunology clinic available in St James’s Hospital.
GPs and other referring healthcare professionals, are welcome to advocate changes in referral triage on behalf of patients, by contacting the department directly. If you feel you should be seen sooner, you should discuss this with your referring doctor who can then contact the medical team to provide further details.
Waiting times for immunology clinic appointments are very long. The single most important factor is that there are not enough clinical immunology doctors available to provide the increasing breadth of service required for an increasing number of patients. The large increases in referrals for allergic diseases are largely responsible for very long waiting times. Unfortunately, at present there are very few specialists in allergic disease in Ireland. We believe that this is a major unmet need across the health service.
The waiting time for routine drug allergy assessment can be more than 24 months.
We are continuing to engage with St James’s Hospital management, Dublin Midlands Hospital Group and the HSE to secure the resources required to improve waiting times and improve our performance.
Immunology departments are operating in Beaumont and Galway Hospitals. Please note clinical immunology services are not available in St Vincent’s Hospital, Mater Hospital, Cork University Hospital, Limerick University Hospital or other regional hospitals.
Contact allergy – please refer patients to our Dermatology Service. Our Immunology Service does not have access to patch testing.
Eczema – in general, patients with eczema should be seen by a dermatologist, unless there is specific evidence of associated serious food allergy. Please note that whilst food allergy is associated with eczema, eczema in adults is not caused by food allergy.
Food intolerance / irritable bowel syndrome – there are no evidence-based diagnostic laboratory tests for food intolerance. Patients with non-allergic gut symptoms (bloating, excessive flatulence, diarrhoea) may benefit from assessment for coeliac disease, or in certain cases testing for lactose intolerance (provided by the Gastroenterology Service). Assessment by a specialist gut doctor (gastroenterologist) may be helpful rule to out other stomach conditions. Food intolerance is best managed by dietary manipulation under the supervision of an experienced dietician. We do not recommend the use of non-evidence based tests or management strategies such as food specific IgG, Vega testing, kinesiology, enzyme potentiated desensitisation or naturopathy. The use of such tests in allergic disorders may be dangerous.
Non-allergic rhinosinusitis – whilst we do offer desensitisation for patients with allergic nasal disease, if there is no evidence of allergic sensitisation on testing then there is no role for immunology services. Most cases of allergic rhinitis should be managed in primary care.
Lyme disease / chronic lyme disease – referrals should be directed to an appropriate infectious disease specialist.
Chronic fatigue syndrome / ME and related disorders – the Immunology Department is currently unable to offer services to manage chronic fatigue syndrome. We do not offer experimental immune system treatments. We advise, in line with NICE (UK) guidelines, that patients with CFS/ME, should engage in a supervised graded exercise programme with supporting cognitive behavioural therapy. Unfortunately, this approach is not available in the Immunology Department or locally in St James’s Hospital at this time.
We understand that many people are waiting for long periods on their immunology appointment and that this is frustrating.
Between 10 and 25% of patients (2015-2017) did not attend their scheduled appointment and these appointment slots are wasted. This is unfortunate for people waiting on a much needed appointment.
In most cases, patients that do not attend their appointment will not be offered a further appointment with us. The referring doctor or GP will be informed.
We do recognise that circumstances change – if you no longer want or need an appointment, please cancel it by contacting the immunology secretary on (01) 416 2928.
The department provides a number of advice services to GPs. These include management of chronic spontaneous urticaria in general practice.
Information regarding the immunology laboratory service, including test repertoire, turnaround times and results, can be found here.