Allergy Service

RHCYP NHS Lothian

Service

The allergy service offers diagnosis and management of allergies including allergy diagnostic testing, avoidance education, auto injector training and food challenges when applicable. A multidisciplinary allergy clinic is held weekly at RHCYP attended by Professor Jurgen Schwarze, Dr Helen Rhodes, Dr David Cordiner, Dr Aziz Sheikh, Juliet Dykes and Vicky McConnachie Allergy Nurse Specialists and Maria Mitchell, Specialist Paediatric Allergy Dietitian. The joint clinic usually provides a one-stop service offering skin prick testing and dietetic advice alongside a medical consultation.
The service also provides weekly clinics at St John’s Hospital
A Nurse led allergy clinic is available twice weekly
A dietetic led allergy clinic is available fortnightly.

Who to refer:

Children with anaphylaxis, i.e. allergy symptoms that affect breathing (cough, wheeze, stridor or breathlessness), the gut (severe prolonged vomiting) or the circulation (faintness, floppiness or signs of shock, collapse)
Children with food allergies who receive regular asthma preventative treatment and/or poorly controlled asthma
Poorly controlled allergic rhinitis only after a trial of daily nasal steroid spray together with a daily non-sedating antihistamine for a minimum of 3 months.
Where diagnosis is not clear and needs to be confirmed or excluded
Children with suspected food allergy who also have severe eczema
Multiple food allergies
Systemic insect sting reactions

Who not to refer:

People over the age of 18 years.
Single uncomplicated food allergies, i.e. not anaphylaxis. These patients may be referred to the General Medical Pediatric Service if not able to be managed in Primary Care
Minor reactions to foods such as strawberries, tomatoes and aubergines are common and do not generally need referral into the allergy service. (See Oral Allergy Syndrome tab above)
Egg allergy (See Egg Allergy tab above)
Non-IgE CMPA – Please refer to Infant Feeding Difficulty Dietics see–Cow’s Milk Protein Allergy (CMPA) – RefHelp (nhslothian.scot)
IgE CMPA – Refer to general paedaitric dietetics – Dietetics – RefHelp
- Advise to avoid cows milk protein and prescribe allergy formula if appropriate (add link to appendix 2 – Prescribing allergy formula’s)
- If combination fed and infant did not previously react to cow’s milk in maternal diet please advise Mum to continue to keep cow’s milk in her diet.
- Dietetics to provide skin prick testing on receipt of referral in order to confirm diagnosis. Dietetics to offer milk free weaning advice and reintroduction at 12 months as appropriate.
- Please advise to avoid lactose free milks/products as these contain cow’s milk protein.
Single urticarial reactions without obvious triggers
Non-allergic chronic urticaria
Well controlled allergic rhinitis, asthma or eczema
Mild to moderate eczema without obvious allergic trigger
Localized insect sting reactions
Delayed type food allergy presenting primarily with gastrointestinal symptoms

How to refer:

Referrals should be made via the SCI gateway
For patients within the city of Edinburgh, East and Midlothian, please refer to RHCYP via Paediatric Allergy Service
For patients within West Lothian, please refer to St John’s via Medical Paediatrics