Allergic reaction An aberrant immune response following repeated exposure to otherwise harmless substances such as animal dander, pollen, dust, mold spores, medications or foods.
Allergic rhinitis (seasonal and perennial) Inflammation of the nasal mucous membranes due to an allergic response to either indoor and/or outdoor allergens.
Allergic contact dermatitis (contact eczema) A type of itchy rash caused by an allergic reaction to specific chemical substances that come in contact with the skin. In North America, the most contact allergen is the metal nickel, used in most jewelry.
Anaphylaxis A medical emergency which involves an acute systemic (affecting the entire body) allergic reaction. It occurs after exposure to an allergen to which a person was previously sensitized. This reaction can be life-threatening.
Angioedema A non-itching reaction in the skin’s underlying tissue marked by swelling and red blotches, this often involves the face and hands, can be very dramatic and even restrict breathing, similar in pathology to hives (urticaria), but occurs in deeper tissue.
Asthma A chronic, inflammatory lung disease characterized by recurrent breathing problems. Episodes of asthma can be triggered by allergens, infection, exercise, cold air and other factors. This condition is becoming more common in both adults and pediatric patients. We treat with newer biological agents such as Xolair, Dupixent, Fasenra, Nucala and Tezspire.
Asthma in pregnancy Pregnant patients with asthma need close monitoring to maximize their lung function and minimized possible adverse effects to the fetus from lack of oxygen or medication reactions. They also need proper selection of medications during pregnancy.
Bronchitis An inflammation of the bronchi (lung airways), resulting in persistent cough. Bronchitis is more common in smokers and in areas with high air pollution.
Drug allergy An adverse immune reaction following contact with otherwise harmless drugs, usually manifested as a rash or other systemic complaints, up to and including anaphylaxis.
Eosinophilic Esophagitis is an allergic condition that happens in the esophagus. The esophagus becomes inflamed and does not contract properly. It can get narrowed and develop rings or abscesses.
Eczema (atopic dermatitis) An inflammation of the skin, usually causing itching and sometimes accompanied by crusting, scaling or blisters. A type of eczema often made worse by allergen exposure is termed “atopic dermatitis.” This condition is particularly common in pediatric patients. Many new treatments are currently available including topical creams (Eucrisa, Opzelura), oral medications (Rinvoq,Cibinqo) and biological injections (Dupixent, Adbry).
Food allergy An adverse immune reaction following contact with otherwise harmless foods, the manifestations of this reaction may range from mild to life-threatening. These reactions may be found in both children and adults.
Immunodeficiency A range of disorders, both inherited and acquired, that result in the dysfunction of part or all of the normal immune response.
Insect hypersensitivity An adverse immune reaction following contact with insect stings (i.e. honeybees or yellow jackets), the manifestations of this reaction may range from mild to life-threatening.
Occupational asthma A respiratory disorder directly related to inhaling fumes, gases, dust or other potentially harmful substances while “on the job.” With occupational asthma, symptoms of asthma may develop for the first time in a previously healthy worker, or pre-existing asthma may be aggravated by exposures within the work place.
Otitis media An inflammation or infection of the middle ear , commonly found in infants and children with allergic rhinitis.
Rhinitis An inflammation of the nasal passages, often due to an allergy to pollen, dust or other airborne substances. Seasonal allergic rhinitis, also known as “hay fever,” is a disorder characterized by sneezing, itching, runny nose accompanied by nasal congestion. The other common form of rhinitis, non-allergic rhinitis, is usually triggered by certain factors, such as strong smells, pollution, particulate matter in the air, smoke or other irritants.
Pet Allergies Cat and Dog allergy are common in households that have pets. We can do allergy testing, and discuss treatment options that best suit your needs.
Sinusitis An acute or chronic inflammatory condition of the sinuses, often caused by a bacterial or viral infection, which can be associated with chronic nasal allergies.
Urticaria (hives) An allergic reaction of the skin which is characterized by the development of itchy, raised welts, most often resembling mosquito bites. There are many reasons why hives occur. Allergy testing and a thorough history taking can be of great value in determining the cause of urticaria. Procedures performed by Dr. Alan Khadavi Treatment and diagnosis of allergic and pulmonary conditions can vary depending on the severity and duration of the discomfort, reaction, and/or condition.
Procedures performed by Dr. Alan Khadavi-Your Allergist/Immunologist
Allergy skin testing The scratch, or more accurately, the prick-puncture test (one of the most common methods) involves placement of a small amount of suspected allergy-causing substances (allergens) on the skin (usually the forearm, upper arm, or the back), and then pricking the skin so that the allergen is introduced under the skin surface. The skin is observed closely for signs of a reaction, usually swelling and redness of the site – a controlled hive with a so-called wheal and flare. Results are usually obtained within about 15-20 minutes, and several suspected allergens can be tested at the same time. A similar method involves injection of a small amount of allergen within the surface of the skin (intradermal skin testing) to test for allergies in adults as a more sensitive version of the skin prick test.
CAP-RAST testing A sensitive and specific blood test for allergies- used in conjunction with allergy skin testing for diagnosis of allergies. It offers the advantage of not having to stop any medicines for the purpose of allergy testing.
Immunotherapy (“allergy shots or allergy vaccinations “) A form of preventive and anti-inflammatory treatment of allergy to substances such as pollen, dust mites, fungi and stinging insect venom. It involves administering gradually increasing doses of the substance (allergen) to which the person is allergic. The incremental increases of the allergen cause the immune system to become less sensitive to the substance over time, which reduces the symptoms of allergy when the substances are encountered in the future. The benefits allergy shots can last for years after a full course of treatment. Allergy shots can be given for the following; pollens, trees, grasses, weeds, animal dander, cats, dogs, dust mites, cockroaches, molds and venom (bees, yellow jackets, wasps, hornets).
Sublingual Immunotherapy We are now treating patients with sublingual immunotherapy, as it has been recently FDA approved. You will need to speak with our treating allergists whether or not this treatment is right for you. It is not covered by most insurance plans. The benefits of sublingual immunotherapy are that you don’t need to come to the doctor once a week for a shot, although you do need to take it daily for it to work. We now offer sublingual immunotherapy for all allergens including trees, grass, weeds, dust, mold, dog and cat. It is very common in Europe, and we currently offer this service to our patients.
Administration of immunomodulatory agents (Biologics) Medications that can increase or suppress immune responses of the body, given for autoimmune diseases or immunodeficiency. Administration of Xolair, a novel treatment for asthma, is one of the newest immunomodulatory agents used in our practice. Studies have shown that it is also effective for chronic idiopathic urticaria (CIU) and it can be given for that too. Nucala which has been approved for severe asthma can also be administered in the office. Other ones used are Fasenra, Dupixent, Tezspire and Adbry. Conditions they are used for are severe asthma, atopic dermatitis (eczema), nasal polyps, eosinophilic esophagitis and hives.
Patch tests A form of skin testing in which suspected allergens are applied to the skin, covered and observed for several days to see if a reaction occurs. This is often used in identifying the possible causes of allergic contact dermatitis, as described above.
Peak Flow A peak flow meter is a small, hand-held device used to manage asthma by monitoring lung capacity. The peak flow meter measures the patient’s ability to expel air from the lungs, or peak expiratory flow rate (PEFR). From these changes in measurement, patients and doctors may determine lung functionality, severity of asthma symptoms, and treatment options. Rhinoscopy A procedure in which a thin, lighted tube is inserted into the nasal cavity to look for possible causes of nasal congestion, loss of sense of smell, or other common sinus problems.
Spirometry/Pulmonary Function Testing This is a test that measures how well the lungs perform. It gives doctors an objective measure of how well the lungs are functioning, and is most useful when assessing for obstructive lung diseases such as asthma or chronic obstructive pulmonary disease (COPD). Often times, a bronchodilator such as albuterol, may be used in the diagnosis of asthma/COPD.
Immune Deficiency Intravenous Immune Globulin (IVIG) are antibodies used to treat patients who have an immune dysfunction. Dr. Khadavi performs immune work ups on patients to check their overall immune competence.