Allergy medicine

The following departments contribute to this multidisciplinary approach and are available to provide effective care:

• Pulmonology
• Dermatology
• Pediatrics
• Internal Medicine
• ENT (Ear,Nose, and Throat)

• Allergic rhinitis
• Asthma, particularly in its most severe forms
• Food allergies
• Food intolerances (lactose, fructose, gluten, FODMAP)
• Drug allergies
• Insect venom allergies
• Chronic sinusitis (with or without polyps)
• Atopic and contact eczema
• Hives (urticaria) with or without swelling (edema)
• Severe generalized allergies (“anaphylaxis”)
• Recurrent infections (primary immune deficiency)

Three steps are proposed:

First consultation, We conduct a detailed medical history (past and present), followed in some cases by allergy skin tests, lung function measurement, and blood tests. An initial treatment plan based on the preliminary diagnosis is then proposed.

Second consultation, We gather all the information and adjust the treatment within a multidisciplinary framework.

Third consultation, We assess the effectiveness of the treatment, taking into account any possible side effects.

Afterward, long-term treatments (pharmacological and biological), as well as avoidance measures and monitoring of treatment adherence, are continued in close collaboration with the referring physician and/or the primary care doctor.

Diagnosing the disease and identifying its causes requires several techniques:

• Skin tests (prick tests) for airborne allergens (“pneumoallergens”)
• Prick tests for “native” food allergens, which requires a “bank” of food samples
• Intradermal skin tests for medications (with both immediate and delayed readings)*
• Patch tests (epicutaneous tests) for contact allergies and certain medications
• Oral provocation tests (for medications and foods)*
• Pulmonary function testing and non-specific bronchial provocation tests
• FeNO measurement (nitric oxide) in exhaled air
• ENT examination by fibroscopy
• Upper digestive endoscopy (esophagus and duodenum)
• (Micro) skin biopsy and video capillaroscopy
• Laboratory tests (molecular Immuno-CAP, CAP-ISAC supplemented by ALEX2, Baso test, TTL, cellular activation tests)
• Laboratory tests to evaluate immune deficiencies, such as assessing the vaccine response

*Performed in a day-hospital setting.

The therapeutic approaches include:

• Avoidance measures (eliminating the cause or causes):
  • Dietary adjustments in collaboration with a dietitian
  • Avoidance of one or more medications and substitution with an alternative treatment
  • Control of indoor pollution in collaboration with the “CRIPI” services (Brussels Environment)
• Specific immunotherapy (desensitization), either oral or subcutaneous
• New targeted biotherapies (according to international guidelines)
• Replacement therapy with immunoglobulins

Regardless of the therapeutic approach, it is very important to check and encourage adherence and correct use of treatments.
This strategy relies on the involvement of a specialized nurse who evaluates the usefulness, possible side effects, and comfort of the prescribed medications.

We perform various assessments for allergic diseases:

• Respiratory allergology
• Food allergology and management
• Food intolerance: lactose, celiac and non-celiac gluten sensitivity, FODMAP intolerance
• Simple or complicated rhinosinusitis
• Dermatologic allergology: contact and skin allergies
• Hymenoptera venom allergies (bee, wasp, horsefly, etc.)

We investigate allergies in the context of asthma, rhinitis, conjunctivitis, food, drug, and skin (contact) allergies through:

• Allergy skin tests
• Intradermal reactions (for medications, bee, wasp, horsefly venom, etc.)
• Patch tests
• Conjunctival, nasal, and non-specific bronchial provocation tests
• Esophageal biopsy (to detect eosinophilic esophagitis)
• Specialized laboratory tests (Immuno-CAP, CAP-ISAC, Baso test)

The multidisciplinary allergy clinic actively contributes to the ULB University Certificate in Clinical Immuno-Allergology

( réf https://www.ulb.be/fr/programme/fc-340 )