Subcutaneous immunotherapy (SCIT) sits in that uncomfortable space between routine and risk. It’s one of the few interventions in allergy that can actually modify disease. But it also carries a small, very real risk of severe reactions. On this episode, Dr. Susan Wasserman, professor at McMaster University and a national leader in immunotherapy, walks through what safety really looks like in practice. And where things still go wrong.

Key Points:

• Systemic reactions are uncommon but not rare
• Safety has improved through better patient selection, standardized extracts, and clinic preparedness
• Uncontrolled asthma is the most important risk factor for severe reactions
• Prior systemic reactions require reassessment, especially if the cause is correctable
• Build-up dosing carries higher risk than maintenance
• Rush and cluster protocols increase risk and need clear justification
• The 30-minute observation period captures most but not all reactions
• Beta blockers and ACE inhibitors may worsen reaction severity without increasing incidence

SCIT is one of the few tools we have that can actually change the trajectory of allergic disease. But it demands discipline. Careful screening. Reliable processes. And a team that’s ready to act when things go sideways.

Because most of the time, it’s safe.
And the rare times it isn’t—that’s where preparation matters most.

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For children born with inborn errors of immunity, bone marrow transplant has long been the closest thing medicine had to a cure. It works — but it comes with chemotherapy, graft-versus-host disease, and a donor search that doesn't always end well. Gene therapy is changing that calculus. Dr. Mariam Hanna speaks with Dr. Nicola Wright, a pediatric hematologist and clinical immunologist at the Alberta Children's Hospital and holder of the Barb Ibbotson Chair of Pediatric Hematology, whose research focuses on developing gene editing platforms for blood and immune disorders.

On this episode, they discuss:

• Why bone marrow transplant is, in Dr. Wright's words, "almost a poor man's gene therapy" and what gene therapy offers instead
• The spectrum of technologies: lentiviral insertion, CRISPR, base editing, and prime editing. What each does, and where each falls short
• Immune reconstitution outcomes across diseases, including over 90% good immune reconstitution in ADA-deficient SCID treated with lentiviral therapy
• How to counsel a family when gene therapy might be an option and why most patients still can't access it
• The "valley of death": why therapies that work in trials are failing to reach patients, and what it will take to cross it
• CAR T-cell therapy in IEI, including a Canadian trial underway for refractory autoimmune disease
• What long-term follow-up looks like and why 15-year post-trial monitoring is now an FDA requirement

The science is outpacing the infrastructure. Dr. Wright's vision of shipping cells instead of patients, in vivo delivery via lipid nanoparticle, no chemotherapy required isn't speculative. The runway is being built. The plane is already flying.

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A signed form isn't consent. It's paperwork. On this episode, Dr. Mariam Hanna is joined by Dr. Lisa Thurgur — emergency physician, award-winning educator, and a physician advisor with the Canadian Medical Protective Association — to unpack what meaningful consent looks like in daily practice. Inadequate consent is one of the most common allegations in CMPA cases, across every specialty.

On this episode:

• The three elements of valid consent — and what capacity actually means
• Why a signed consent form is not the same as an informed patient
• Implied versus expressed consent: when each applies, and when to re-consent
• Why serious risks like anaphylaxis — and death — must be disclosed, and how to frame that conversation
• Consent in minors: why maturity — not age — determines capacity (with one exception in Quebec)
• What to do when parents disagree — or a minor refuses
• Patients recording their visits: what physicians need to know
• PARQ: a four-point mnemonic for structuring both the conversation and the chart note
• The say-back technique: asking patients what they understood, and why it matters

Done well, consent isn't something you do in addition to practicing good medicine. It improves outcomes, strengthens adherence, and reduces medical-legal risk. In other words, it is good medicine.

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An inconsolable cry. A baby who's just not acting right. Tongue thrusting. Lip licking. Scratching at their own tongue. These aren't the symptoms that make it into standard diagnostic criteria — but they might be the clearest signal a non-verbal child can give. On this episode, Dr. Mariam Hanna is joined by pediatric allergist and immunologist Dr. Katherine Anagnostou to explore how anaphylaxis presents in infants and toddlers, why the standard criteria don't always apply, and how allergists can help caregivers recognize — and treat — serious reactions in children who can't yet put words to what they're feeling.

On this episode:

• Why modified criteria for infant and toddler anaphylaxis matter
• Behavioral signs like irritability, clinginess, lethargy, or withdrawal as red flags
• The role of context and timing in recognizing reactions
• Surrogate symptoms — tongue thrusting and lip licking for oral itching, drooling, horse cry
• Why urticaria shows up in 90% of infant anaphylaxis cases
• Epinephrine dosing: the 0.1 mg option for infants 7.5-15 kg and safety of 0.15 mg in smaller babies
• Why not every infant who receives epinephrine needs the ED
• Second-dose timing: five minutes, not ten
• Novel delivery routes on the horizon — intranasal and sublingual epinephrine

Dr. Anagnostou returns to one principle throughout: parents generally know their children pretty well. The job of the allergist isn't to create fear or overcomplicate recognition — it's to help families spot what's different, understand the context, and feel equipped to act when it matters.

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Milk has a special talent for creating chaos in clinic. One day it’s mucousy stools and a terrifying diaper photo, the next it’s hives after yogurt, delayed vomiting with lethargy, or a family that’s been dairy-free for years with no improvement in eczema. On this episode, Dr. Mariam Hanna is joined by pediatric allergist and clinical immunologist Dr. Farah Khan to walk through the many ways “milk problems” show up — and how allergists can avoid overdiagnosis, unnecessary testing, and prolonged elimination diets that may do more harm than good.

On this episode:

• Why allergic proctocolitis (cow’s milk protein intolerance) is often overdiagnosed
• When skin testing and IgE testing are useful 
• Understanding the difference in lactose intolerance 
• How baked milk can be used to improve quality of life in IgE-mediated milk allergy
• What makes FPIES to milk tricky, including earlier-than-expected reactions
• Why dairy elimination for eczema or EOE needs caution and frequent reassessment

Across each of these scenarios, Dr. Khan returns to the same principle: eliminating dairy should never be a one-and-done decision. Revisiting the diagnosis, retrying thoughtfully, and weighing quality of life alongside risk are essential — especially when prolonged avoidance can set the stage for the very allergy clinicians are trying to prevent.

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On this episode of The Allergist, Dr. Mariam Hanna turns the focus to how allergists LEARN to recognize when common presentations may signal a deeper immune problem — and how that diagnostic instinct is built, taught, and sustained.

She’s joined by Tamar Rubin, pediatric allergist and clinical immunologist, Assistant Professor at the University of Manitoba, and a national leader in immunology education. Dr. Rubin makes the case that inborn errors of immunity are not a fringe interest, but central to understanding immunology across allergy, asthma, infection, and biologic therapies — and that allergist-immunologists are the specialists uniquely trained to recognize and teach this.

On this episode, they discuss:

• Why allergist-immunologists “own” inborn errors of immunity, and why teaching these conditions is part of the specialty’s responsibility
• Moving trainees away from memorizing rare syndromes and toward recognizing immune pathways, patterns, and warning signs
• How patient-based teaching, case discussions, OSCEs, and national academic half-day curricula help trainees develop diagnostic “spidey sense”
• What happens when you build dedicated immunology clinics, and how volume and exposure increase once you start looking
• The importance of national collaboration and collegial networks when managing ultra-rare immune conditions
• Practical ways allergists in community practice can stay engaged with inborn errors of immunity, even with limited volume or access to specialized testing
• Knowing when — and how — to ask for help matters as much as knowing the diagnosis.

Because in the end, inborn errors of immunity aren’t just about rare diseases. They sharpen how allergists think, teach, and listen when the immune story doesn’t quite fit.

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Timing of repeat epinephrine to inform pediatric anaphylaxis observation periods: a retrospective cohort study
For most children treated with epinephrine, prolonged emergency department observation may be unnecessary, with two hours appearing sufficient unless cardiovascular features are involved.

Two-year data of tapered dupilumab shows high effectiveness in chronic rhinosinusitis with nasal polyps with NSAID-exacerbated respiratory disease
In real-world practice, most patients with CRSwNP maintained excellent control while spacing dupilumab doses far beyond every two weeks, challenging long-term fixed dosing assumptions.

Remibrutinib and chronic spontaneous urticaria
This trial marks a major shift for CSU, introducing an oral, targeted option that delivers rapid symptom control and meaningful rates of complete remission.

A randomized trial comparing direct challenges to penicillin skin testing for outpatient low-risk penicillin allergy evaluations in pregnancy
For pregnant patients with low-risk penicillin allergy histories, direct oral challenge proved safe, efficient, and more streamlined than traditional skin testing.

Age differences in inducible laryngeal obstruction in adult populations
Inducible laryngeal obstruction appears common in older adults, often presents more subtly, and frequently masquerades as asthma or anaphylaxis.

Taken together, these papers reflect a broader shift in allergy care: less reflexive caution, more precision, and a growing willingness to question long-standing habits when better data emerge. Whether it’s shortening observation times, tapering biologics, simplifying drug allergy evaluations, or recognizing long-ignored mimics of allergic disease, the 2025 literature nudges allergists toward care that is more precise, less reflexive, and still clinically vigilant.

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“We have to keep in mind that urticaria has to be treated until it's completely gone. So, absolute control of the disease.” — Dr. Hermenio Lima

Chronic spontaneous urticaria has long been managed with the goal of complete symptom control. But for many patients, that goal remains elusive. In this episode of The Allergist, Dr. Mariam Hanna talks with dermatologist and clinical immunologist Dr. Hermenio Lima about the updated urticaria guidelines—and how new treatment options are giving clinicians more ways to act, and more hope for getting patients all the way to control.

On this episode:

• What’s new in the 2025 guideline—including additional second-line options beyond antihistamines
• Why nearly 40% of patients may need to escalate to biologics
• How remibrutinib compares to omalizumab and what its trials revealed
• What the CUPID studies say about dupilumab, especially in biologic-naive patients
• Key safety signals and clinical considerations for the new treatment options
• How to move toward full disease control—and why suboptimal outcomes are no longer acceptable

Complete control is still the destination, but the path to get there is about to get a lot more flexible.

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                                                                                                          — Dr. Carina Venter

Dr. Mariam Hanna sits down with Dr. Carina Venter, a leading dietitian and researcher in food allergy prevention and management. They get into the everyday realities of feeding infants and children in allergy practice, from early introduction to texture challenges, growth concerns, and the rise of allergen-free processed foods.

On this episode

• How nutrition supports the microbiome and immune system, and helps clinicians navigate the anxiety common in food-allergy clinics.
• Practical early-feeding strategies: pairing low-allergen foods with allergens, starting early, and keeping allergens in the diet once introduced.
• How to approach families whose infants reject certain textures or flavours, and realistic ways to incorporate allergens like egg and peanut.
• Why baby-led weaning may not work well for allergenic foods, especially in babies with eczema.
• Nutritional red flags: milk allergy, multiple food allergies, and texture delays that warrant dietitian referral.
• Concerns about ultra-processed allergen-free products and how emulsifiers may affect gut health.

This episode brings nutrition back to the centre of allergy practice. Dr Venter’s guidance keeps things practical — diverse diets, consistent allergen exposure, and attention to growth and texture — so families can feel confident and kids can learn to enjoy food safely.

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Dr. Zachary Rubin joins Dr. Mariam Hanna for a candid look at the “difficult and misinformed” patient — the growing phenotype every allergist now manages weekly. A double board-certified pediatrician and allergist-immunologist with a massive social media footprint, Dr. Rubin breaks down how misinformation spreads, why it resonates, and how clinicians can approach these encounters without burning out or burning bridges. From TikTok-fuelled certainty to patients demanding full panels, he offers a practical, clinician-first playbook for navigating the mess.

On this episode:

• Why today’s misinformation is stickier, faster, and more emotionally charged than a decade ago, and how parasocial trust amplifies it.
  
  
• How the “nugget of truth” inside misinformation gives it power and how to dismantle it without escalating conflict.
  
  
• A clinic-ready strategy to approach resistant patients: open-ended questions, triaging what must be corrected now, and focusing on one actionable change at a time.
  
  
• Why continuity, follow-up, and small pieces of information over time often outperform a single “big correction.”
  
  
• How to use shared decision-making to reframe testing and treatment choices, especially when patients arrive convinced they need “the full panel.”
  
  
• Practical tools to support patient understanding, including targeted education resources, structured discharge summaries, and multimodal materials for different learning styles.
  
  
• How teams can protect each other through debriefs, preparation, and collaborative communication during high-stress encounters.

A grounded, real-world conversation for clinicians who balance patient frustration, digital misinformation, and the realities of modern allergy practice.

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Chronic sinusitis doesn’t just clog the nose—it can drag down quality of life, complicate asthma, and leave patients caught between specialists. Dr. Mariam Hanna talks with Dr. Andrew Thamboo, rhinologist at St. Paul’s Sinus Centre in Vancouver and clinical associate professor at UBC, about how to identify, manage, and treat this stubborn condition. A leader in chronic sinus disease research, Dr. Thamboo explains how understanding inflammation, using the right investigations, and choosing the right therapies can make a real difference for patients who feel like nothing works.

In this episode:

• How to distinguish chronic rhinosinusitis from acute sinusitis, and why type 2 inflammation matters
  
  
• The role of CT scans in diagnosis and when to order one before referral
  
  
• What nasal endoscopy patterns reveal about atopy and when allergy testing changes the treatment plan
  
  
• Why saline irrigations combined with topical steroids remain the baseline therapy, and why oral corticosteroids are falling out of favour
  
  
• When medical management has gone far enough and surgery becomes the next step
  
  
• The evolving place of biologics, cost considerations, and how biosimilars could shift the future of care
  
  
  
• Why managing sinus disease seriously improves both airway and overall health

Sinus disease may suck, but as Dr. Thamboo explains, understanding inflammation, anatomy, and timing can make all the difference for patients and physicians alike.

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Tregs have been called therapists, peacekeepers, and now—thanks to this year’s Nobel Prize—front-page immunology. Dr. Vy Kim joins Dr. Mariam Hanna to unpack why these cells might hold the key to everything from tolerance to therapy response, and what allergists should be watching for next.

• How Tregs bridge central and peripheral tolerance—and why that matters in allergy.
• What their dysfunction reveals about the origins of allergic disease.
• Why allergen-specific Tregs could signal immunotherapy success.
• How far we are from clinical testing and therapeutic manipulation.
• What “Goldilocks” balance really looks like inside the immune system.
• The unanswered questions that will shape the future of Treg-based interventions.

It’s not every day the Nobel Prize lines up with what’s happening in your clinic. This is one of those days.

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Allergy season may be winding down, but for allergists, the work never really stops. This is the moment between ragweed and winter — a brief respite before the cycle begins again. On this episode, Dr. Mariam Hanna is joined by Dawn Jurgens, Director of Operations and Quality Management at Aerobiology Research Laboratories. She breaks down the science behind pollen and spore counts, why forecasts matter, and how shifting seasons are changing the game for patients and clinicians alike.

• Timothy grass is the most common and potent trigger globally, while birch remains the most clinically relevant pollen in Canada. Pine releases large amounts of pollen but isn’t highly allergenic.
  
  
• Pollution and thunderstorms can make pollen more potent by breaking it apart and exposing allergenic epitopes, intensifying symptoms.
  
  
• Cross-reactivity stems from conserved epitopes, meaning patients sensitized to one pollen may react to related species — or even certain foods.
  
  
• Mold spores, especially Alternaria, Cladosporium, and Basidiospores, can mimic ragweed season and are major fall culprits.
  
  
• Canada’s pollen seasons are starting earlier than they did 30 years ago, though the fall season hasn’t yet extended.
  
  
• Simple strategies — like showering before bed, keeping windows closed, using filters, brushing pets outside, and checking reliable forecasts — can meaningfully reduce exposure.

Pollen season may be taking a break, but planning for the next wave starts now.

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Vaccines can stir anxiety for patients and confusion for clinicians, especially when biologics enter the mix. Dr. Mariam Hanna is joined by Dr. Anne Pham-Huy, clinical immunologist at CHEO, member of the Special Immunization Clinic Network, NACI member, and chair of Immunize Canada. Together, they break down the science of vaccine responses and tackle some of the trickiest questions allergists face in daily practice.

On this episode:

• The major types of vaccines — from live attenuated to mRNA — and what sets them apart.
  
  
• Why live vaccines often produce strong, durable protection, but may require caution in certain patients.
  
  
• How adult immunization is still underutilized, with gaps in boosters, pneumococcal, HPV, and influenza coverage.
  
  
• Which “special populations” need tailored vaccine strategies, including patients on immunosuppressants, transplant recipients, and those with chronic disease.
  
  
• Practical guidance on timing vaccines around biologic use and which precautions truly matter.
  
  
• When to check titers and antibody responses — and why it’s only relevant for select patient groups.
  
  
• Strategies for counselling vaccine-hesitant patients with empathy, focusing on disease risk and building trust.
  
  
• What’s next: combination mRNA vaccines and nirsevimab for RSV prevention in infants.

The questions are simple — are they vaccinated, special, or special enough — but the answers matter.

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Eczema care has become a world of creams, cleansers, oils, and myths — but what actually works? Dr. Mariam Hanna is joined by Dr. Melinda Gooderham, assistant professor at Queen’s University and consultant physician at the Peterborough Regional Health Centre. As principal investigator for more than 250 clinical trials, Dr. Gooderham brings both evidence and practical wisdom to the table.

On this episode, they explore:

• Why barrier repair remains the cornerstone of therapy, and how humectants, emollients, and occlusives play distinct roles
  
  
• The evidence behind natural oils (and why olive oil is out while coconut, sunflower seed oil, and shea butter may have a place)
  
  
• Bathing basics: frequency, water temperature, and whether bleach baths still matter
  
  
• How to choose topical steroid potency and when to pivot toward non-steroidal options
  
  
• The promise of newer agents: calcineurin inhibitors, PDE-4 inhibitors like roflumilast, and topical JAK inhibitors
  
  
• When to escalate to systemic therapy, with itch and quality of life as key markers

Eczema may be complex and misunderstood, but Dr. Gooderham reminds us that consistent barrier care, adequate product use, and asking the right questions about itch can simplify management and improve patient outcomes.

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Mastocytosis is rare, complex, and often confused with other mast cell disorders. To help clinicians cut through the confusion, Dr. Mariam Hanna welcomes Dr. Mathieu Picard, allergist and clinical immunologist, who has built a dedicated practice caring for patients with mast cell diseases. Together, they explore what physicians need to know about diagnosis, monitoring, and management.

On this episode:

• Adults: Around 80% of adults with skin lesions have systemic mastocytosis, and the disease typically persists.
• Children: Pediatric cases are almost always cutaneous and often resolve by puberty.
• When to order a tryptase — and why a normal result doesn’t rule out systemic disease
• The role of KIT D816V mutation testing and why biopsy technique matters
• Key risks to monitor in indolent systemic mastocytosis: anaphylaxis, osteoporosis, and rare progression to advanced disease
• Practical tips for patient care, including venom immunotherapy considerations, osteoporosis screening, and symptom control strategies

Mastocytosis may be rare, but it doesn’t take uncommon skill to spot — just the right tools, a sharp eye, and maybe a tongue depressor scratched five times.

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Dr. Imran Satia, Respirologist and Associate Professor at McMaster University and Canada Research Chair in Chronic Cough, joins Dr. Mariam Hanna to walk clinicians through a practical, evidence-based approach to diagnosing and managing chronic cough. With decades of research and clinical experience, Dr. Satia explains how to define chronic cough and its subtypes, recognize red flags, and navigate the common — and less common — causes that keep patients coughing for years.

On this episode, you’ll hear:

• The difference between chronic cough, refractory chronic cough, and unexplained chronic cough — and why the terminology matters for treatment.
  
  
• The key investigations every patient with chronic cough should have, and how to interpret results in the context of cough hypersensitivity.
  
  
• The role and real-world value of methacholine challenge, FeNO, induced sputum, and sputum culture in refining diagnosis and guiding therapy.
  
  
• Why empiric ICS–LABA and PPI trials aren’t always the right move — and when they are.
  
  
• Management strategies for patients who don’t respond to initial treatment, starting with a low-dose morphine trial, followed by neuromodulators, speech therapy, and clinical trial options.

By the end of the episode, you’ll have a clear, step-by-step framework for assessing chronic cough, avoiding unnecessary treatments, and helping even the most refractory patients find relief.

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Dr. Amiirah Aujnarain has built a community of 80,000 followers by blending evidence-based allergy education with a candid, human presence online. On this episode of The Allergist, she joins Dr. Mariam Hanna to examine how social media is shaping allergy conversations—sometimes for better, sometimes for worse.

From Benadryl challenges to dupilumab searches on TikTok, patients are turning to social media for answers long before they see a specialist. Dr. Aujnarain shares how she’s meeting them where they are, and why she sees it as both a responsibility and a creative outlet.

This episode covers:

• How allergy misinformation spreads on social media—and what physicians can do about it
  
  
• Why patients are using TikTok like Google, and how that’s changing referral patterns
  
  
• What physicians should consider before joining social media, including boundary-setting, time commitment, and emotional labour
  
  
• The upside of being a visible, human face of allergy care—and the backlash that can come with it

Whether you’re thinking about launching your own account or simply wondering how your patients are being influenced online, this conversation is an honest look at the power and pitfalls of digital engagement.

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Pediatric gastroenterologist Dr. Vish Avinashi joins Dr. Mariam Hanna for an episode that jumps head first into the overlapping world of allergy and GI. From ARFID to EOE, they talk about the murky middle ground where food fears, immune triggers, and gut symptoms collide—and how allergists can better navigate it all with the help of a friendly gastroenterologist.

• How to recognize ARFID and why history, not testing, is your best diagnostic tool
• Common pitfalls in celiac diagnosis—and why a positive TTG doesn’t always mean celiac
• New, and surprising treatments for IBS, including nerve stimulation and gut-directed hypnotherapy
• What the microbiome research does—and doesn’t—tell us
• Understanding fibrosis in EOE and when to skip dietary elimination

When it comes to navigating the overlap between allergy and GI, remember: always learning, always listening, always befriending a gastroenterologist.

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On this episode of The Allergist, Dr. Mariam Hanna welcomes Dr. Lana Rosenfield to unpack the complexities of managing allergic conditions during pregnancy and postpartum. With hormones shifting, the immune system recalibrating, and anxiety about medication safety running high, allergic disease can be especially tricky to manage during this time. Dr. Rosenfield offers practical insights for clinicians supporting pregnant patients with conditions like asthma, rhinitis, chronic urticaria, and food allergy, while navigating a landscape of limited data and heightened patient concerns.

On this episode:

• How the maternal immune system changes during pregnancy—and why it may exacerbate allergic conditions
  
  
• Safe options for managing allergic rhinitis, including which medications to avoid
  
  
• Asthma in pregnancy: monitoring frequency, preferred inhalers, and why under-treatment is riskier than treatment
  
  
• Atopic dermatitis: mimics to watch for, which topicals are safe, and what we know (or don’t) about dupilumab
  
  
• Managing chronic urticaria with second-generation antihistamines and omalizumab
  
  
• Food allergy and anaphylaxis: fetal risks, symptom variations, and why epinephrine remains essential
  
  
• What to do with patients already on immunotherapy, and why it should never be initiated during pregnancy
  
  
• Biologics and breastfeeding: limited evidence, but emerging reassurance
  
  
• Preconception counselling and postpartum care: optimizing control while minimizing risk
  
  

Dr. Rosenfield emphasizes shared decision-making, lowest effective dosing, and the clinical resources she trusts when evidence is limited. It’s a thoughtful and clinically grounded conversation to support allergists managing allergic conditions through pregnancy and beyond.

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The Allergist is produced for CSACI by PodCraft Productions

Creams that sting and rashes that won’t quit —welcome to the complex world of contact dermatitis. Dr. Rebecca Pratt joins Dr. Mariam Hanna to unpack why diagnosing and managing this condition is anything but straightforward.

Dr. Pratt is an allergist and clinical immunologist in St. Catharines, Ontario, with a passion for dermatoimmunopathology and practical tools that empower patients. She breaks down when to patch test, what to suspect, and how to help patients take control.

On this episode:

• Why 80% of contact dermatitis cases are irritant—not allergic
  
  
• Clues that point to allergic contact dermatitis, especially in recurring facial, hand, or foot rashes
  
  
• How to approach patch testing in adults and kids, including when immunosuppressants or UV exposure may interfere
  
  
• What to do when results are negative—and why that still matters
  
  
• The reality of managing allergens found in foods, not just topicals
  
  
• Why there’s no one-size-fits-all answer to the sunscreen question—and how physical blockers stack up

There may be no cure for contact allergy, but there’s power in knowing what to avoid.

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Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

What if that tough case in your allergy clinic isn’t just unusually severe, but fundamentally different? On this episode of The Allergist, Dr. Mariam Hanna speaks with pediatric immunologist Dr. Catherine Biggs about primary atopic disorders, rare inborn errors of immunity that masquerade as everyday allergy but demand a very different approach.

Dr. Biggs breaks down the clinical signs that should raise your suspicion and explains why early recognition and genetic testing can make all the difference. From STAT6 gain of function to when (and when not) to reach for dupilumab, this episode offers a roadmap for spotting zebras.

On this episode:

• What makes primary atopic disorders different from severe, polygenic allergic disease
  
  
• Red flags: when eczema, asthma, or food allergy suggest an underlying immune disorder
  
  
• Which patients warrant genetic testing—and how to approach it in practice
  
  
• The most important lab work to order (and why it might still come back normal)
  
  
• STAT6 gain of function and other key genetic culprits allergists should know
  
  
• When biologics are appropriate, and when they might delay definitive treatment
  
  
• The power of collaborative care: how one hospital built a severe atopy working group

Don’t let these patients fall through the cracks, because sometimes, it’s not “just” allergy.

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The Allergist is produced for CSACI by PodCraft Productions

How do we move from the exam room to the frontlines of discovery? On this episode of The Allergist, Dr. Mariam Hanna talks with Dr. Gord Sussman about how curiosity—not a research grant—launched his decades-long contribution to allergy science. From identifying the early signs of latex allergy to shaping the treatment landscape for urticaria and hereditary angioedema, Dr. Sussman shares what keeps him asking the next question, and how any allergist can get involved.

On this episode:

• Why Dr. Sussman initially thought he’d never pursue research—and what changed his mind
  
  
• How one nurse's anaphylactic reaction to latex launched a field of study
  
  
• What it was like to design and run early research trials for food allergy challenges and peanut desensitization
  
  
• Why recruiting patients for trials has become harder—not easier—over time
  
  
• What makes a good research coordinator and why infrastructure is critical
  
  
• How to identify patients who may be open to research, and when not to push
  
  
• Why some promising drugs never reach market—and what frustrates Dr. Sussman most
  
  
• What advice he gives to allergists who are research-curious but hesitant
  
  

You don’t need a lab coat to help change practice. Just curiosity, commitment—and maybe a really good clinical coordinator.

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The Allergist is produced for CSACI by PodCraft Productions

— Dr. Herminio Lima

Chronic spontaneous urticaria has long been managed with the goal of complete symptom control. But for many patients, that goal remains elusive. In this episode of The Allergist, Dr. Mariam Hanna talks with dermatologist and clinical immunologist Dr. Herminio Lima about the updated urticaria guidelines—and how new treatment options are giving clinicians more ways to act, and more hope for getting patients all the way to control.

On this episode:

• What’s new in the 2025 guideline—including additional second-line options beyond antihistamines
  
  
• Why nearly 40% of patients may need to escalate to biologics
  
  
• How remibrutinib compares to omalizumab and what its trials revealed
  
  
• What the CUPID studies say about dupilumab, especially in biologic-naive patients
  
  
• Key safety signals and clinical considerations for the new treatment options
  
  
• How to move toward full disease control—and why suboptimal outcomes are no longer acceptable

Complete control is still the destination, but the path to get there is about to get a lot more flexible.

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The Allergist is produced for CSACI by PodCraft Productions

When it comes to nasal polyps, the landscape is shifting fast. On this episode of The Allergist, Dr. Mariam Hanna is joined by otolaryngologist Dr. Yvonne Chan to talk about how biologics, surgery, and multidisciplinary care are working together to reshape care for this stubborn condition. From recognizing key symptoms to navigating the latest therapeutic options, Dr. Chan shares practical insights to help physicians better support patients with nasal polyps.

On this episode:

• How to differentiate nasal polyps from other causes of chronic nasal obstruction
  
  
• When imaging should be ordered and what findings are suggestive of polyps
  
  
• The role of allergy testing and comorbid conditions like asthma and AERD
  
  
• How biologics have changed the game—and which patients are ideal candidates
  
  
• When surgery is still needed, even in the era of advanced medical therapies
  
  
• The importance of long-term follow-up and multidisciplinary collaboration

Listen now, because when it comes to managing nasal polyps, the right team and the right tools can make all the difference.

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The Allergist is produced for CSACI by PodCraft Productions

What makes a great medical educator—and how do you actually become one? On this episode, Dr. Mariam Hanna is joined by Dr. Lori Connors, an allergist, seasoned teacher, and newly appointed Associate Dean of Continuing Professional Development and Medical Education at Dalhousie University. 

They explore the journey to becoming a great medical educator, how competency by design is reshaping training, and how to support the next generation of learners.

Here’s what you’ll learn:

• How Dr. Connors’ path to teaching began with a strong mentor (and a family full of educators)
  
  
• The evolution of medical education: from informal teaching to formal training, portfolios, and competence committees
  
  
• Why observation and feedback—good feedback—are key to coaching for change
  
  
• How residency programs are adapting to incorporate wellness, fatigue risk management, and cultural competence
  
  
• The case for moving beyond shame-based “pimping” toward safer, more effective ways of questioning and challenging learners
  
  
• Strategies to meet different learning styles and generations—plus why podcasts and other media are a growing part of the mix
  
  
• Challenges facing medical educators today, from limited clinic space to a changing educational landscape

Whether you're shaping the next generation or figuring out your own place in it, this episode offers practical insights and a reminder that great educators never stop learning themselves.

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The Allergist is produced for CSACI by PodCraft Productions

Is your schedule running you—or are you running your schedule?

On this episode of The Allergist, Dr. Mariam Hanna is joined by pediatric allergist and clinical immunologist Dr. Scott Cameron to talk about the chaos of clinical practice and how to take back control. With tips that go far beyond time management, Dr. Cameron shares practical strategies for streamlining clinic operations, handling unpredictable days, and investing in smarter workflows—without burning out.

On this episode:

• The hidden culprits of clinic inefficiency—and how intake forms can help fix them
• How to triage patients better, with tips for predicting complex visits
• How to schedule around unpredictability—like anaphylaxis challenges—so they don’t derail your entire day
• The “project day” concept: why setting aside time for workflow projects can save you hours down the line
• Cutting down on admin overload with physician-driven templates, better patient communication, and targeted uses of AI
• How pairing with trainees can preserve teaching time and clinic flow
• Making time-saving tools work for you: from smart goals and macros to QR codes and intake automations

Get practical. Get faster. Get home on time. It’s all about working smarter—not harder.

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The Allergist is produced for CSACI by PodCraft Productions

— Dr. Luis Murguia Favela

Immune dysregulation isn’t just about infections—autoimmunity, inflammation, and even malignancy can be clues that something deeper is at play. With over 500 known inborn errors of immunity, allergists are increasingly on the front lines of identifying these conditions. But when should we suspect immune dysregulation, and what does cutting-edge treatment look like today?

Dr. Mariam Hanna is joined by Dr. Luis Murguia Favela, pediatric immunologist and founding chair of the Clinical Immunology Network for Canada, to break down the growing world of immune dysregulation and how allergists can spot it.

On this episode:

• What is immune dysregulation? How inborn errors of immunity have expanded far beyond primary immune deficiencies.
• The 11th warning sign: Why early-onset, unusual, or difficult-to-treat autoimmunity, inflammation, or malignancy should raise red flags.
• Not just for kids: Many inborn errors of immunity present in childhood, but 30% of cases emerge in adults—and often go unrecognized.
• Suspicion before sequencing: Why a strong clinical suspicion is more important than access to genetic testing.
• Targeted treatments and the future of immunology: From biologics to gene therapy, where immune dysregulation treatment is headed.

With a growing number of identified inborn errors of immunity, the role of allergists in spotting immune dysregulation has never been more critical. Be suspicious, always.

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The Allergist is produced for CSACI by PodCraft Productions

Penicillin allergy is one of the most commonly reported drug allergies—but here’s the twist: most people who carry this label aren’t actually allergic. So how did we get here, and what can be done to fix it?

On this episode, Dr. Mariam Hanna sits down with Dr. Kimberly Blumenthal, an allergist, immunologist, and clinical researcher at Massachusetts General Hospital, and an associate professor at Harvard Medical School. Dr. Blumenthal is internationally recognized for her work on penicillin allergy and the real-world impact of unnecessary labels on patient care, antibiotic resistance, and health equity.

We cover:

• Why penicillin allergy is so commonly (and incorrectly) diagnosed
• How de-labelling can improve antibiotic stewardship and patient outcomes
• Risk stratification: who needs testing, who can go straight to a challenge, and who should avoid penicillin?
• The role of allergists in leading the charge on de-labelling efforts
• Special populations, including pregnant patients, children with serum sickness-like reactions, and marginalized communities with less access to allergy care
• International practices that complicate the picture—like routine penicillin pre-screening in some countries

With the vast majority of penicillin allergy labels being inaccurate, this episode highlights why it's time to stop assuming and start testing.

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The Allergist is produced for CSACI by PodCraft Productions

– Dr. Doug Mack

Food allergies aren’t one-size-fits-all, but we don’t talk enough about thresholds—the amount of an allergen it actually takes to trigger a reaction. Should every patient be following the same strict avoidance rules? Or should we be aiming for something more precise?

To help us make sense of thresholds, we welcome back Dr. Douglas Mack, pediatric allergist, clinical immunologist, and Vice President of CSACI. Dr. Mack is known for his work on food allergy treatment, including oral immunotherapy, epinephrine use, and—you guessed it—thresholds.

On this episode, Dr. Mack and Dr. Mariam Hanna dig into:

• What a threshold actually is and why it matters in clinical practice – How thresholds shape food challenges, oral immunotherapy, and allergen risk assessments, even when we don’t explicitly discuss them.
• How much allergen is too much? – Why two patients with the same allergy can have vastly different tolerance levels, and why strict avoidance isn’t always the best approach.
• Eliciting dose, cumulative dose, and the numbers that matter most – How clinical trials define reaction thresholds, and how allergists can use these data points to guide patient care.
• Real-world factors that affect thresholds – How co-factors like exercise, illness, sleep deprivation, and even hot showers can shift a patient’s threshold and increase reaction risk.
• Precautionary labels, airplane bans, and the science behind food allergy risk in everyday life – What research tells us about trace exposures, why precautionary labeling varies worldwide, and how allergists can help patients navigate the gray areas of food safety.

Thresholds aren’t just theoretical—they impact how we advise patients, assess risk, and tailor treatments. Dr. Mack walks us through the science behind these numbers and how allergists can apply them in daily practice.

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The Allergist is produced for CSACI by PodCraft Productions

Is omalizumab set to change the food allergy landscape? And how should clinicians use it in practice? On this episode of The Allergist, Dr. Mariam Hanna sits down with Dr. Brian Vickery, professor of pediatrics and chief of the Division of Allergy and Immunology at Emory University, to break down what allergists need to know about this new FDA-approved biologic for food allergies.

• What makes omalizumab a milestone treatment? The first FDA-approved biologic for food allergies, covering multiple allergens and all age groups from one year and up.

• How does it work? A deep dive into its mechanism, from intercepting free IgE to its broader immunological effects.

• The implications of the OUTMATCH trial: What the numbers really say about efficacy across different foods, including why cashew results looked weaker than peanut but might just be an artifact of study design.

• Who should consider it? A practical look at patient selection—where omalizumab might be an ideal option and where OIT or other strategies may still be preferable.

• Where do we go from here? The future of biologics in food allergy treatment, including whether other monoclonals like dupilumab could play a role down the line.

Join us as we unpack the data, the clinical applications, and the questions still left unanswered.

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The Allergist is produced for CSACI by PodCraft Productions

On this episode of The Allergist, Dr. Mariam Hanna is joined by Dr. William Anderson to explore one of the most pressing and evolving questions in asthma care: remission. Together, they unpack the concept of asthma remission, what it truly means for patients and physicians, and how modern therapies are shaping its future.

Dr. Anderson helps break down:

• What remission really means: The key criteria—from absence of symptoms to stable lung function—and the differences between spontaneous remission and remission on treatment.
• The role of biologics: Are these cutting-edge therapies just controlling asthma, or could they be disease-modifying?
• Risk factors for persistent asthma: Why early exacerbations, smoking, and other factors can influence the trajectory of the disease.
• Transitioning from pediatric to adult care: How to ensure adolescents stay on track with self-management during this critical handoff.
• Future directions in asthma care: The exciting possibilities of AI, early interventions, and electronic medication monitoring to improve outcomes.

If you’re curious about the potential for asthma remission or looking for actionable ways to refine your approach to care, this episode is packed with valuable insights. Equip yourself with fresh perspectives and practical tools to help your patients stay on the path to better health.

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The Allergist is produced for CSACI by PodCraft Productions

Could sublingual immunotherapy (SLIT) be the peanut allergy solution allergists have been waiting for? In this episode, Dr. Mariam Hanna welcomes Dr. Edwin Kim, Division Chief of Pediatric Allergy and Immunology at the University of North Carolina, to dive into the science, practicality, and potential of SLIT. With a reputation for safety and ease of use, SLIT is gaining traction—but as Dr. Kim emphasizes, the evidence for other foods like milk, egg, and tree nuts remains extremely limited.

On this episode:

• What is SLIT? A low-dose therapy held under the tongue, offering bite-proof protection with minimal side effects like mouth itch, making it a low-risk option for many patients.
• Why choose SLIT? Why some patients prefer SLIT’s simplicity, including fewer restrictions on exercise and observation, compared to oral immunotherapy.
• Why peanuts? SLIT shows strong results for peanuts, but research on expanding to milk, egg, and tree nuts is still in its early stages, with unique challenges for each food.
• Who benefits most? Younger patients who thrive on routine and those seeking protection from accidental exposures without needing to eat large quantities of allergens.
• What lies ahead? Optimizing dosing for different foods, improving outcomes for patients with low thresholds, and expanding access to non-peanut allergens.

Whether you’re curious about incorporating SLIT into clinical practice or exploring its limits, this episode delivers evidence-based insights. Tune in now to see if SLIT is the right fit for your patients!

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Venture into the evolving landscape of food allergy management as Dr. Mariam Hanna welcomes Professor Jonathan Hourihane, a leading figure in pediatric allergy and immunotherapy from the Royal College of Surgeons in Ireland. Together, they explore the latest strategies in dietary advancement therapies and the critical role of early food introduction.

On this episode:

Early Introduction: Professor Hourihane emphasizes the importance of introducing allergenic foods early to prevent long-term allergies. He challenges traditional cautious approaches and highlights the effectiveness of starting reintroductions at home for allergens like milk and egg.

Impact of Parental Anxiety: How parental emotions play a crucial role. Professor Hourihane shares his findings on the negative effects of high parental anxiety on the success of food reintroduction. He underscores the need for allergists to provide support to help parents navigate these challenges confidently.

Advocacy in Allergy Management: Reflecting his passion for patient advocacy, Professor Hourihane advocates for a proactive approach to managing food allergies. He discusses the necessity of empowering both patients and their families to take informed steps toward reintroducing allergenic foods safely and effectively.

Shifting Perspectives: They discuss how these approaches necessitate a shift in how allergists view food allergies—from a condition to be feared to one that can be actively managed through strategic, informed actions.

Join Dr. Hanna and Professor Hourihane for an insightful discussion that promises to reshape your understanding of food allergy management, emphasizing early intervention and patient empowerment. This episode is a must-listen for anyone involved in allergy care, offering essential insights that could transform your clinical approach. 

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The Allergist is produced for CSACI by PodCraft Productions

When it comes to managing anaphylaxis, epinephrine is the gold standard. But even with its life-saving potential, misconceptions abound, and newer delivery methods like nasal and sublingual formulations are raising questions for allergists and patients alike. In this episode, Dr. Mariam Hanna sits down with Dr. Paul Turner, pediatric allergist, clinical immunologist, and global expert on anaphylaxis, to explore the science, controversies, and clinical realities surrounding epinephrine use.

On this episode:

• Anaphylaxis demystified: Why the "ABC" symptoms (airway, breathing, circulation) are crucial for timely diagnosis.
• Epinephrine explained: How it works, why timing matters, and when it’s not enough.
• Alternative delivery methods: Intranasal and sublingual epinephrine—why Dr. Turner is skeptical about their use in clinical practice without robust evidence of efficacy.
• When epi fails: Understanding the limitations of autoinjectors in severe reactions and the role of IV infusions.
• Improving patient confidence: Strategies for addressing fears and teaching appropriate use to improve outcomes.

Whether you're an allergist navigating these evolving treatment landscapes or a clinician seeking clear guidance for patient care, this episode provides critical insights and practical advice. Tune in to strengthen your understanding of epinephrine’s role in anaphylaxis management and gain clarity on when—and how—it should be used.

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The Allergist is produced for CSACI by PodCraft Productions

Every week, we’re ingesting the equivalent of a credit card’s worth of plastic—through food, water, and even the air we breathe. In this episode, Dr. Mariam Hanna speaks with Dr. Magdalena Zemelka-Wiecek, associate professor of clinical immunology at Wroclaw Medical University, about the pervasive presence of plastics in our environment and their potential role in influencing human health. For allergists, understanding the links between plastic exposure and emerging health concerns—including its impact on the immune system—is increasingly relevant in patient care.

On this episode:

• Nano and microplastics explained: What they are, how they form, and why they’re turning up in surprising places like tap water and even breast milk.
• Health risks and immune implications: Exploring the connections between plastic exposure and inflammatory disorders, with emerging evidence on gut and liver health.
• Plastics and the microbiome: How microplastics might disrupt the gut microbiome, a key player in immune function.
• One Health perspective: Why reducing plastic use benefits not just individuals but ecosystems, emphasizing a shared responsibility for health.
• Actionable insights: Tips for counseling patients on simple steps to limit exposure while research continues.

Whether you're exploring the intersections of environmental and immune health or seeking guidance for patient discussions, this episode offers evidence-based insights and practical advice tailored to your clinical practice.

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The Allergist is produced for CSACI by PodCraft Productions

For many, pets are like family, which makes pet allergies a particularly sensitive issue. On this episode, Dr. Mariam Hanna invites Dr. Shahzad Mustafa, Chief of Allergy, Immunology, and Rheumatology at Rochester Regional Health, to explore practical, evidence-based approaches for managing pet allergies in patients who can’t imagine life without Fido or Fluffy. Together, they break down the latest on diagnosis, medical management, and the myths that often cloud pet allergy discussions.

On this episode:

• Pet allergies explained: How exposure, family history, and genetics factor in.
• Hypoallergenic pets: Do they make a difference in reducing allergic reactions?
• Is the pet causing asthma or eczema? Understanding pets as contributors, not causes.
• Environmental controls: what’s the evidence that this actually works and what’s just wishful thinking.
• Effective medical therapies: From nasal corticosteroids to antihistamines and nasal ipratropium.
• Exploring immunotherapy options: Shots, sublingual tablets, and even intralymphatic injections.

Whether it’s dogs, cats, or anything furry in between, this episode offers compassionate, informed guidance for balancing allergy management with the realities of pet ownership. Tune in to get clarity on how to help patients breathe easy—without breaking their bond with their beloved pets.

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On this episode of The Allergist, Dr. Mariam Hanna teams up with Dr. Timothy Olynych, a clinical immunologist and allergist and PhD in mast cells, to unravel the mystery of mast cell activation syndrome (MCAS). This elusive condition requires some serious detective work, with clues scattered across a complex array of symptoms that don’t always add up. Together, they crack the case on how to spot MCAS in its various disguises and offer a roadmap for managing this puzzling disorder.

On this episode:

• Understanding Mast Cell Activation Syndrome: MCAS is a complex condition characterized by a constellation of symptoms rather than one clear diagnostic feature. Dr. Olynych highlights why it’s often confused with other conditions, making diagnosis a challenge for clinicians.
• The Role of Tryptase Testing: Learn how tryptase testing is crucial in diagnosing MCAS, especially when levels spike during symptom flares, though normal levels don’t always rule out MCAS.
• Common Misconceptions and Comorbidities: Dr. Olynych addresses the frequent confusion between MCAS and conditions like POTS and Ehlers-Danlos syndrome. 
• Treatment Approaches: Dr. Olynych outlines a treatment approach that mirrors how chronic spontaneous urticaria is managed, using H1 and H2 blockers and mast cell stabilizers like cromolyn sodium. 
• Patient Care Beyond the Allergist’s Office: This episode highlights the importance of a multidisciplinary approach to MCAS, including when to refer patients to other specialists. 

Join us as we dig deeper into the enigma of mast cell activation syndrome, uncovering practical clues and actionable insights for healthcare providers eager to crack the case on this complex and often misunderstood condition.

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On this episode of The Allergist, Dr. Mariam Hanna teams up with Dr. Priya Bansal, a triple board-certified allergist, to tackle the challenges of managing food allergies and the anxiety that often comes with them. Together, they walk through real-world cases that allergists frequently encounter, offering practical strategies to support patients and families.

On this episode:

• Introducing Allergens at Home: Handling parents’ hesitancy to introduce allergens like tree nuts in infants who already have a known allergy. Dr. Bansal offers approaches for building trust and using shared decision-making.
• What’s Not a Food Allergy: Dr. Hanna and Dr. Bansal discuss the common misconceptions around what qualifies as a food allergy and how to communicate with patients who might confuse intolerances or other reactions with true food allergies.
• Self-Carrying Epinephrine in Schools: Practical tips for helping children and teens manage epinephrine autoinjectors at school, including discussing comfort levels, age appropriateness, and new technologies like nasal epinephrine.
• School-Wide Allergy Bans: The pros and cons of school-wide bans on allergens like peanuts, and why such bans may cause more harm than good. Dr. Bansal shares alternative strategies for managing food allergies in schools without increasing social isolation.
• Health-Related Anxiety After a Reaction: Managing patients, especially children, who develop restrictive eating behaviors or heightened anxiety following a food allergy reaction. Discover when to involve mental health professionals and how to address fear in the clinic.

Join us as we explore food allergy management and anxiety, with actionable insights designed to support both healthcare providers and patients navigating the challenges of food allergies.

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Managing drug allergies can be a delicate balancing act, especially when life-saving medications are involved. On this episode of The Allergist, Dr. Mariam Hanna is joined by Dr. Christine Song, an Assistant Clinical Professor at the University of Toronto and drug allergy lead at St. Michael’s Hospital. Together, they unpack the complexities of drug allergies, from distinguishing them from other adverse drug reactions to navigating the tricky terrain of desensitization.

On this episode:

• Understanding Drug Allergies: What distinguishes a true drug allergy from other adverse reactions, and why some medications are more prone to trigger allergies?
• Common Triggers and Mechanisms: Insights into why penicillins, beta-lactams, and fluoroquinolones frequently cause allergic reactions, and how both immediate and delayed allergic mechanisms play a role.
• Diagnostic Challenges: The importance of a thorough patient history, the role of skin testing, and why timelines and details are critical.
• Shared Decision-Making: How allergists work with patients to prioritize which allergies to test, de-label, or manage, with special considerations for pediatric and adult populations.
• Desensitization Protocols: The art and science of safely reintroducing necessary medications through desensitization, and why this process isn’t one-size-fits-all.
• Pre-Medication Strategies: Why there’s no ‘right’ premedication protocol due to a lack of strong evidence supporting their overall effectiveness.
• Unique Cases and Exceptions: From managing chemotherapy allergies to tuberculosis treatments, when and why allergists might push the boundaries of traditional desensitization protocols.
• Practical Tips for Healthcare Providers: Best practices for referring patients, documenting allergic reactions, and communicating effectively to ensure patients receive the care they need.

Prepare to learn how to navigate the complex world of drug allergies with confidence and care.

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The Allergist is produced for CSACI by PodCraft Productions

As allergy seasons ebb and flow, there’s one drug that maintains its place in household medicine cabinets: Benadryl. On this episode, Dr. Mariam Hanna sits down with Dr. Stuart Carr, Chief Medical Officer at Snö Asthma and Allergy in Abu Dhabi and past president of the CSACI, to tackle the lingering myths and outdated uses of first-generation antihistamines. From their history to their ongoing role in primary care, they uncover the risks of these older drugs, and the clear benefits of second-generation antihistamines.

On this episode:

• The pharmacology of first-generation antihistamines: How do they really work?
• Are first-generation antihistamines still necessary?
• Debunking the myth of Benadryl as a first-line treatment for allergic reactions.
• Undesirable side effects: impaired cognitive function, disrupted sleep, increased risk of dementia, and cardiac risks like ventricular arrhythmias.
• Special considerations for pediatric and elderly populations.
• The future of antihistamine treatments: What’s on the horizon?

Arm yourself with the latest knowledge to “fight the good fight” against first-generation antihistamines. 

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The Allergist is produced for CSACI by PodCraft Productions

As the leaves begin to fall, and the wasps begin to invade every patio lunch, Dr. Mariam Hanna sits down with Dr. David Golden, a leading expert on venom allergies and retired associate professor from Johns Hopkins. Together, they explore the swarm of complexities surrounding venom immunotherapy, from the nuances of diagnosis to emerging treatments on the horizon.

In this episode:

• Understanding venom allergies: The basics and beyond
• Large local reactions vs. systemic reactions: What’s the real risk?
• The role of skin testing vs. serum IgE in diagnosing venom allergies
• Venom immunotherapy: How effective is it, really?
• Emerging trends and treatments in venom allergy management
• Practical advice for managing venom allergies 

Prepare to get the buzz on everything venom-related in this insightful conversation. Tune in now!

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The Allergist is produced for CSACI by PodCraft Productions

Join Dr. Mariam Hanna for a comprehensive discussion on Food Protein-Induced Enterocolitis Syndrome (FPIES) with Dr. Anna Nowak-Wegrzyn, a leading expert in pediatric allergy and immunology at NYU Grossman School of Medicine. Dr. Nowak-Wegrzyn sheds light on this unique and often perplexing condition, offering critical insights for healthcare providers.

On this episode:

Understanding FPIES:

• Dr. Nowak-Wegrzyn explains FPIES, a non-IgE mediated food allergy that manifests differently from traditional food allergies. She details the typical presentation of FPIES, including severe vomiting, lethargy, and pallor, which can occur a few hours after food ingestion.

Difference in Presentation Between Children and Adults:

• Learn about how FPIES presents in different age groups. While it typically begins in infancy, Dr. Nowak-Wegrzyn discusses the mysterious cases where FPIES emerges in adults who have tolerated the triggering food for years.

How FPIES Differs from IgE-Mediated Food Allergies:

• Understand the key differences between FPIES and IgE-mediated food allergies. Dr. Nowak-Wegrzyn outlines why skin and blood tests may be negative in FPIES cases, despite the severity of symptoms.

Prognosis and Counseling Parents:

• Discover the prognosis for children with FPIES, with many outgrowing the condition by age three to five. Dr. Nowak-Wegrzyn emphasizes the importance of educating and empowering parents through careful counseling and shared decision-making.

Management and Treatment:

• Dr. Nowak-Wegrzyn discusses current strategies for managing FPIES, including dietary modifications, careful introduction of new foods, and the potential use of ondansetron for managing symptoms at home. She also addresses the use of epinephrine in atypical FPIES cases with IgE sensitization.

Tune in to this episode for an in-depth exploration of FPIES, offering practical advice and valuable insights for healthcare providers navigating this challenging condition.

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The Allergist is produced for CSACI by PodCraft Productions

Join Dr. Mariam Hanna for a deep dive into secondary immunodeficiencies with Dr. Samira Jeimy, an assistant professor in the Division of Clinical Immunology and Allergy at Western University. Dr. Jeimy shares her extensive knowledge on acquired immunodeficiency, providing valuable insights for healthcare providers.

On this episode:

Understanding Acquired Immunodeficiency:

• Dr. Jeimy explains acquired immunodeficiencies, also known as secondary immunodeficiencies, and how they result from external factors rather than genetic anomalies.

Types and Diagnosis:

• Understand the diagnostic process, including measuring immunoglobulin levels and considering clinical and family history.

Clinical Manifestations and Triggers:

• Learn about the diverse clinical manifestations of acquired immunodeficiency and common triggers, such as infections, chronic diseases like diabetes and renal failure, and medications.
• Dr. Jeimy discusses the controversial and often misunderstood causes of immunodeficiency, including stress and post-COVID conditions.

Management and Treatment:

• Discover current strategies for managing acquired immunodeficiencies, including the use of immunosuppressive treatments and the importance of early diagnosis and intervention.
• Dr. Jeimy emphasizes the need for personalized medicine and collaboration among healthcare providers for effective treatment.

Patient Care and Support:

• Dr. Jeimy underscores the importance of comprehensive care and support for patients with acquired immunodeficiencies.
• She highlights the significance of early involvement of immunologists in the patient journey to optimize treatment outcomes.

Tune in to this episode for an in-depth exploration of acquired immunodeficiency, offering valuable insights and practical advice for healthcare providers.

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Join Dr. Mariam Hanna in an enlightening conversation with Dr. Stephen Betschel, an associate professor in the Department of Medicine and Clinical Immunologist and Allergist at St. Michael's Hospital, University Health Network. Dr. Betschel, a global authority on hereditary angioedema (HAE), shares his extensive knowledge on this rare and potentially life-threatening condition.

On this episode:

Understanding Hereditary Angioedema:

Dr. Betschel provides a detailed explanation of HAE, an autosomal dominant condition characterized by C1 inhibitor deficiency. He discusses how this deficiency leads to the overproduction of bradykinin, causing swelling in various parts of the body, including the hands, feet, face, abdomen, and throat.

Types and Diagnosis:

Explore the different types of HAE (type 1, type 2, and hereditary angioedema normal) and the importance of accurate diagnosis. Dr. Betschel explains the diagnostic process, which includes measuring C4 and C1 inhibitor levels and function, and emphasizes the role of clinical and family history in identifying potential cases. Genetic testing can also be useful in certain cases.

Clinical Manifestations and Triggers:

Learn about the varying clinical manifestations of HAE, which can differ significantly even among patients in the same family. Dr. Betschel highlights common triggers for HAE attacks, such as infections, trauma, and spontaneous episodes, emphasizing the importance of understanding these triggers for effective management.

Management and Treatment:

Discover the latest advancements in HAE treatment, including on-demand therapies for acute attacks and long-term prophylaxis options. Dr. Betschel discusses medications such as Icatibant, intravenous and subcutaneous C1 inhibitors, and the promising future of oral treatments and gene therapy.

Patient Care and Support:

Dr. Betschel underscores the importance of providing comprehensive care and support for HAE patients. He advises healthcare providers to engage with patients actively, optimize attack control, and improve quality of life through personalized treatment plans.

Tune in to this episode for an in-depth exploration of hereditary angioedema, offering valuable insights and practical advice for healthcare providers.

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The Allergist is produced for CSACI by PodCraft Productions

Dr. Mariam Hanna sits down with Dr. Anne Ellis, professor of medicine and chair of the Division of Allergy and Immunology at Queen's University, to explore the intricacies of Pollen Food Allergy Syndrome (PFAS), also known as Oral Allergy Syndrome. Dr. Ellis, a leading expert in allergic diseases, guides listeners through the complex landscape of PFAS, offering insights into diagnosis, management, and patient care.

On this episode:

Understanding Pollen Food Allergy Syndrome:

Dr. Ellis provides a comprehensive overview of PFAS, explaining how it affects primarily the mouth and tongue but can impact the entire GI tract. She discusses the common allergens associated with PFAS, such as birch pollen, and the cross-reactivity from fruits like apples and tree nuts.

Diagnosis and Misconceptions:

Explore the diagnostic process for PFAS. Dr. Ellis clarifies the difference between PFAS and other food allergies, emphasizing the role of accurate diagnosis through skin tests and serum-specific IgE testing.

Management Strategies:

Learn about effective management strategies for PFAS. Dr. Ellis shares insights on how to reduce symptoms through avoidance of raw fruits and vegetables and the role of immunotherapy in treating underlying environmental allergies.

Patient Care and Red Flags:

Dr. Ellis highlights key aspects of patient history that may indicate more severe allergic reactions, discussing the importance of distinguishing between local symptoms and systemic IgE-mediated reactions.

Advice for Primary Care Providers:

Gain valuable tips for primary care providers on recognizing and managing PFAS. Dr. Ellis emphasizes the significance of a detailed medical history and the reassurance that most PFAS cases do not require an epinephrine auto-injector.

Tune in to this episode for an in-depth discussion on Pollen Food Allergy Syndrome, offering practical advice and expert insights for both healthcare providers and patients.

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The Allergist is produced for CSACI by PodCraft Productions

Join Dr. Mariam Hanna as she sits down with Dr. Tiffany Wong who pushes back on the persistent and unfounded skepticism about whether preschoolers can be diagnosed with asthma. Dr. Wong is an associate clinical professor at the University of British Columbia and the medical lead of the BC Children's Hospital allergy clinic. She covers the intricacies of diagnosing and managing preschool asthma, dispels common myths and emphasizes the importance of accurate diagnosis and effective management in young children.

On this episode:

Diagnosing Preschool Asthma:

Dr. Wong clarifies the myths and realities of diagnosing asthma in preschool children. She emphasizes that a detailed medical history and physical examination can often suffice, debunking the misconception that spirometry is always necessary.

Management Strategies:

Gain insights into effective management strategies for preschool asthma. Dr. Wong discusses the importance of categorizing patients according to their risk of future exacerbations, which helps in tailoring treatment plans for both healthcare providers and families.

Follow-Up Care:

The critical role of regular follow-up in managing preschool asthma is highlighted. Dr. Wong stresses that continuous monitoring allows for better understanding of each patient's evolving clinical narrative and ensures timely adjustments to treatment plans.

Empowering Families:

Learn how to support families dealing with preschool asthma. Dr. Wong provides valuable tips on training families to recognize and report symptoms accurately, ensuring they are equipped to manage their child's condition effectively.

Tune in to this episode for a deep dive into preschool asthma, with practical tips and expert insights for both healthcare providers and caregivers.

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The Allergist is produced for CSACI by PodCraft Productions

Dr. Mariam Hanna sits down with Dr. Maureen Petersen, a pediatric allergist and immunologist from North Carolina Chapel Hill to explore the challenges of managing chronic illness from the perspective of both the physician and the parent. Dr. Petersen brings a unique personal connection to this topic, having navigated her daughter's chronic illnesses while pursuing a medical career. 

On this episode:

Navigating Chronic Illness: Dr. Petersen shares her experiences with treating chronically ill children, emphasizing the importance of empathy and understanding in patient-caregiver relationships. She illustrates the unique challenges faced by families and offers strategies to improve communication and support.

Physician's Perspective: Dr. Petersen discusses the impact of chronic illness on physicians, highlighting techniques for maintaining compassion and methods to avoid burnout while delivering high-quality care.

Self-Care for Physicians: Practical advice on how physicians can manage their well-being amidst demanding careers. Dr. Petersen emphasizes the importance of finding joy, setting personal goals, and prioritizing self-care to maintain a balanced and fulfilling medical career.

Empowering Families: Learn how to support families dealing with chronic illness. Dr. Petersen provides valuable tips on encouraging open communication, validating parent’s experiences, and offering necessary resources without overwhelming them, ensuring they feel seen and heard.

Tune in to this episode for an insightful discussion on the intricacies of chronic illness care and the vital role of self-care for physicians, offering practical advice and expert perspectives for healthcare providers and caregivers alike.

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The Allergist is produced for CSACI by PodCraft Productions

                                                                                                                        -- Patient of Dr. Philippe Begin

Join Dr. Mariam Hanna as she sits down with Dr. Philippe Begin, a renowned expert in allergy and immunology from the University of Montreal. They dive into the complexities of adult food allergies, distinguishing them from childhood allergies and discussing both clinical insights and patient experiences.

On this episode:

Understanding Adult Food Allergies: Dr. Begin explains the unique characteristics of adult food allergies, including the differences in allergens and symptoms between adults and children. He sheds light on the under-researched area of adult food allergy practice.

Diagnosis and History: Learn about the critical elements in diagnosing IgE-mediated food allergies in adults. Dr. Begin emphasizes the importance of timing, symptom duration, and consistency in patient history to accurately identify food allergies.

Management Strategies: Dr. Begin shares his approach to managing adult food allergies, highlighting the importance of recognizing patients' experiential knowledge and their tolerance to risk. He discusses the role of food challenges and the careful use of food diaries.

Psychosocial Aspects: Explore the psychological and social dimensions of living with food allergies as an adult. Dr. Begin talks about the varying reactions to food allergies, from fear to confidence, and how past experiences shape these responses.

Empowering Patients: Discover how empowering patients to manage their food allergies can transform their lives. Dr. Begin's stories of patients taking control of their conditions provide valuable insights for both patients and healthcare providers.

Tune in to this episode for a comprehensive look at the evolving field of adult food allergies, offering practical advice and expert perspectives that are essential for anyone dealing with this condition.

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Join Dr. Mariam Hanna as she welcomes Dr. Michael Cyr, a leader in allergy and clinical immunology, to explore the vital role of shared decision-making in the modern practice.

On this episode:

Understanding Shared Decision-Making: Dr. Cyr breaks down the concept of shared decision-making, emphasizing its importance in integrating patient preferences with evidence-based medicine. He highlights the need for physicians to present all treatment options and their associated risks and benefits clearly.

Recognizing and Overcoming Biases: Dr. Cyr discusses the cognitive biases that affect both patients and physicians. He shares strategies for identifying these biases and ensuring they do not impede the decision-making process.

Effective Communication: Dr. Cyr stresses the importance of taking time to listen to patients. By understanding their priorities and fears, physicians can better guide them through their treatment options. He provides practical advice on framing risks and benefits to help patients make informed choices.

The Art of Medicine: Highlighting the art of medicine, Dr. Cyr shares his approach to balancing strong medical advice with patient autonomy. He uses examples such as oral food challenges to illustrate how different patients may make different decisions based on their unique perspectives.

Building Therapeutic Relationships: Dr. Cyr emphasizes the importance of maintaining a strong therapeutic relationship. He advises physicians to be patient and persistent, acknowledging that not all decisions will be straightforward and may require ongoing dialogue and trust-building.

Join Dr. Hanna and Dr. Cyr for an enlightening discussion on how shared decision-making can enhance patient care and improve outcomes in allergy and immunology. This episode is essential for healthcare professionals seeking to refine a balanced approach to patient-centered care and evidence-based practice.

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Venture into the evolving landscape of food allergy management as Dr. Mariam Hanna welcomes Professor Jonathan Hourihane, a leading figure in pediatric allergy and immunotherapy from the Royal College of Surgeons in Ireland. Together, they explore the latest strategies in dietary advancement therapies and the critical role of early food introduction.

On this episode:

Early Introduction: Professor Hourihane emphasizes the importance of introducing allergenic foods early to prevent long-term allergies. He challenges traditional cautious approaches and highlights the effectiveness of starting reintroductions at home for allergens like milk and egg.

Impact of Parental Anxiety: How parental emotions play a crucial role. Professor Hourihane shares his findings on the negative effects of high parental anxiety on the success of food reintroduction. He underscores the need for allergists to provide support to help parents navigate these challenges confidently.

Advocacy in Allergy Management: Reflecting his passion for patient advocacy, Professor Hourihane advocates for a proactive approach to managing food allergies. He discusses the necessity of empowering both patients and their families to take informed steps toward reintroducing allergenic foods safely and effectively.

Shifting Perspectives: They discuss how these approaches necessitate a shift in how allergists view food allergies—from a condition to be feared to one that can be actively managed through strategic, informed actions.

Join Dr. Hanna and Professor Hourihane for an insightful discussion that promises to reshape your understanding of food allergy management, emphasizing early intervention and patient empowerment. This episode is a must-listen for anyone involved in allergy care, offering essential insights that could transform your clinical approach. 

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Asthma remains a formidable foe, particularly when it escalates to its severe form. This episode of "The Allergist," Dr. Mariam Hanna, explores the complexities of severe asthma and the revolutionary impact of biologic therapies.

Dr. Jason Lee, a leading expert in allergy and immunology, sheds light on the evolution of asthma treatment. Gone are the days when inhalers and corticosteroids were our only options. Today, biologics offer a promising frontier, not just to manage but potentially to rewrite the course of the disease. Dr. Lee demystifies these powerful medications, tackling common concerns and highlighting the essential role of patient education in fostering adherence.

Dr. Lee offers several actionable tips for physicians on managing severe asthma with biologics. He advises on the importance of patient education about the mechanisms and benefits of biologics to enhance adherence and reduce anxiety about these new treatments. He emphasizes the need for regular monitoring of lung function and inflammation markers to tailor therapy effectively. And Dr. Lee highlights the use of stepped-care approaches and discusses strategic timing for introducing or discontinuing biologic therapy based on patient response and overall asthma control. 

For allergists and healthcare professionals keen on cutting-edge treatments for severe asthma, this discussion is a treasure trove of practical insights and innovative strategies.

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Hives are probably one of the most misunderstood rashes by the general public. Hives are not life-threatening, but they're debilitating. They're not an allergy, but they're often blamed for being one. They're a marker of autoimmunity with little to do with one particular disease and their course and triggers in one particular person is at best challenging to predict.

Dr. Moshe Ben-shoshan tackles the intriguing world of chronic urticaria; cutting through common misconceptions, and walking us through the latest in diagnostic strategies and management options for hives. From the targeted effectiveness of second-generation antihistamines to the advanced treatment possibilities offered by biologics like omalizumab, and even the role of immunosuppressants such as cyclosporine. Special attention is given to the nuances of chronic urticaria in children versus adults.

Emphasizing the critical role of disease scoring systems, Dr. Ben-shoshan explains how these tools are vital for assessing severity and guiding treatment decisions. The conversation also sheds light on the diagnostic value of blood tests, showcasing the multifaceted approach required to effectively manage hives.

Dr. Ben-shoshan tip-toes into the delicate territory of how to handle the increasing requests for testing and dietary modifications. We also take a quick glimpse into the future of urticaria management including targeted pediatric guidance and new biologics on the horizon. 

This episode offers an indispensable resource for allergists and healthcare professionals seeking to enhance their understanding of chronic urticaria. It’s packed with practical insights and a look towards promising advancements in the field.

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On this episode, Dr. Mariam Hanna is joined by Dr. Adam Byrne, an expert allergist and clinical immunologist, to unravel the complex relationship between climate change and allergic diseases. Dr. Byrne sheds light on how rising global temperatures, increased pollution, and changing ecosystems are not just environmental issues but are directly impacting the prevalence and severity of allergic conditions.

Together, they dissect the science behind why we're seeing an uptick in cases of asthma, allergic rhinitis, and atopic dermatitis. But the conversation doesn't stop at diagnosis and treatment; it also covers practical advice for allergists and patients alike on mitigating the health impacts of climate change. From advocating for cleaner air policies to adjusting daily routines, Dr. Byrne offers actionable strategies to address the evolving landscape of allergies.

This episode is essential listening for anyone in the allergy field, providing a comprehensive overview of the challenges and opportunities that lie ahead in managing allergies in a changing climate. Whether you're a healthcare professional or someone navigating the complexities of living with allergies, Dr. Byrne's insights offer valuable guidance for adapting to our planet's new normal.

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Dr. Mariam Hanna is joined by Dr. David Stukus, a leading pediatric allergist and clinical immunologist from Nationwide Children's Hospital in Columbus, Ohio. Together, they dive into the critical issues surrounding food allergy diagnostics and the latest advancements in treatment options, including developments in the field of oral immunotherapy (OIT) and the recent FDA approval of Omalizumab for food allergies.

Dr. Stukus debunks common misconceptions about testing and emphasizes the importance of a nuanced approach to interpreting results when diagnosing food allergies He advocates for evidence-based practices and the necessity of individualized treatment plans, highlighting the role of clinicians in guiding patients through the complexities of managing food allergies.

The conversation also explores the future of food allergy treatments, with Dr. Stukus expressing optimism about the potential for more personalized therapies that cater to the unique needs of each patient. He stresses the importance of shared decision-making between clinicians and patients, ensuring that treatment choices are informed, thoughtful, and tailored to achieve the best possible outcomes.

This episode is a must-listen for allergists aiming to keep ahead of the evolving landscape of food allergy management, offering deep insights into the challenges, innovations, and hopes for the future. 

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On this episode of "The Allergist," we explore what leadership in medicine actually means with Dr. Zainab Abdurrahman, an accomplished allergist and clinical immunologist. Dr. Abdurrahman, who wears many hats including that of an assistant clinical professor of pediatrics at McMaster University and the incoming president-elect of the Ontario Medical Association, shares her insights on what it means to be a leader in the medical field.

Leadership, as Dr. Abdurrahman explains, is not just about being at the forefront; it's about inspiring and motivating others, guiding teams towards a common goal, and sometimes, leading from behind to allow others to shine. This episode is not just about the theoretical aspects of leadership but also about its practical applications in the challenging landscape of healthcare.

Dr. Abdurrahman's journey is a testament to the diverse forms leadership can take, from being the team lead in mock codes to shaping the future direction of healthcare in Ontario. She discusses the challenges and opportunities that come with being a female leader in medicine, breaking stereotypes, and paving the way for future generations.

So, whether you're an aspiring leader, a medical professional, or someone curious about the intersection of leadership and medicine, this episode offers valuable insights and inspiration. Join Dr. Mariam Hanna and Dr. Zainab Abdurrahman on "The Allergist" as they explore the essence of leadership in medicine and how it shapes the healthcare landscape.

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On this episode of "The Allergist," we're climbing the food ladder with Dr. Douglas Mack, a pediatric allergy, asthma, and immunology specialist. Dr. Mack brings his expertise to the table, discussing the nuances of milk and egg allergies in children. Are all allergies created equal? Spoiler alert: they're not. We dive into the world of phenotypes, genetic markers, and the big question – can we predict who's going to outgrow their allergies and who's in it for the long haul?

We're not just talking science; we're talking practical, real-world applications. Dr. Mack sheds light on the shift from 'ladders' for non-IgE mediated food allergy to IgE mediated ones. It's a journey through the evolution of allergy treatments.

And for those thinking, "What about the risks?" – we've got you covered. Dr. Mack doesn't shy away from discussing the potential dangers and the importance of understanding patient-specific risks. It's a candid conversation about the realities of treating food allergies, the challenges allergists face, and the hope for future advancements.

So, grab your headphones and join us. Whether you're a seasoned allergist or just starting to climb the allergy ladder, "The Allergist" is here to guide you every step of the way. 

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Join Dr. Mariam Hanna in a fast paced conversation with Dr. Victoria Cook, a trailblazer in Quality Improvement, as they discuss how QI is not just reshaping patient care but also revitalizing the healthcare workforce by mitigating burnout.

On this episode:

• Unveiling the science and strategy behind Quality Improvement and its profound impact on healthcare systems and patient outcomes.

• Demystifying the Model of Improvement and the Plan-Do-Study-Act (PDSA) cycle, and their instrumental role in driving systematic changes in healthcare.

• Addressing the common challenges in implementing QI and unveiling practical solutions to overcome these hurdles.

• Highlighting the significant role of QI initiatives in reducing physician burnout, fostering a healthier work environment, and ensuring the well-being of healthcare professionals.

• Gaining insightful perspectives on the future of QI in medicine, its growing prominence, and its potential to redefine patient care and healthcare delivery.

Don't miss out on this deep dive into QI because, you are already doing Quality Improvement, you just need to do it well. Listen now!

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Join us on this eye-opening episode, where we explore the latest breakthroughs in allergy and immunology with Dr. Matthew Greenhawt as he walks us through the pivotal articles of 2023 that are redefining the field.

On this episode:

• Review penicillin allergy delabeling and why this is ready to incorporate into your medical practice.
• Understand the evidence for various atopic dermatitis treatment strategies using evidence-based graded recommendations.
• Discover the potential of dupilumab in its two newest indications - eosinophilic esophagitis and COPD. 
• Delve into our latest understanding of epinephrine doses and future directions in research on this fundamental medication.
• Exclusive insights into the EPITOPE trial from the lead author.

This episode is a must-listen for allergists and immunologists looking for a quick literature review and key highlights from 2023. Tune in now for a journey into the heart of the articles that will change the field of allergy!

Links to articles mentioned in the episode:

The Safety of the Direct Drug Provocation Test in Beta-Lactam Hypersensitivity in Children: A Systematic Review and Meta-Analysis - PubMed (nih.gov) 

Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations - PubMed (nih.gov)

Dupilumab in Adults and Adolescents with Eosinophilic Esophagitis - PubMed (nih.gov)

Dupilumab for COPD with Type 2 Inflammation Indicated by Eosinophil Counts - PubMed (nih.gov)

Optimal dose of adrenaline auto-injector for children and young people at risk of anaphylaxis: A phase IV randomized controlled crossover study - PubMed (nih.gov)

Phase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy - PubMed (nih.gov)

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Have an idea for the show or a comment, send us a text!

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Venture into the realm of allergic rhinitis as Dr. Mariam Hanna welcomes Dr. Anne Ellis, co-author of the latest Canadian guidelines for this common condition. Together, they unravel the complexities of this disease and explore the latest treatment protocols.

On this episode:

• Defining Allergic Rhinitis: Dr. Ellis sheds light on what allergic rhinitis really is and the driving force behind the new guidelines.
• Testing for Immunotherapy: Serum specific IgE vs. skin prick testing – which is more effective for identifying the right candidates?
• First-Line Defense: The role of second-generation antihistamines and nasal corticosteroids, and why first-generation antihistamines fall short.
• Combining Forces: The effectiveness of combination therapies and the place of leukotriene receptor antagonists in treatment.
• Immunotherapy in Focus: Why it's time to consider immunotherapy earlier, including sublingual and subcutaneous options.
• Customized Care: Tailoring treatment to individual allergen profiles and addressing the rare but notable side effect of eosinophilic esophagitis.
• Empowering Patients: Urging those with allergic rhinitis to seek proactive treatment and consider the long-term benefits of immunotherapy.

Dive deep into the world of allergic rhinitis and emerge with a wealth of knowledge that could change your approach to treatment. Don't miss out on these critical insights. Listen now!

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

Join Dr. Mariam Hanna in an enlightening conversation with Dr. Edmond Chan, a leading voice in eosinophilic esophagitis (EoE). Dive into the ever-evolving landscape of this intriguing condition and explore the latest in medical management.

On this episode:

• Understanding EoE: Redefining a Decade of Change.

• The Allergist's Role: Navigating Patient Management and Dietary Choices.

• Steroids and Biologics: Breaking Down Treatment Options.

• The Art of Shared Decision-Making in EoE Treatment.

• Future Frontiers: The Imperative for Ongoing EoE Research.

• Food Elimination Risks and Oral Food Challenges: What Patients Need to Know.

Physicians, empower yourselves with this comprehensive guide to EoE, and join us in fostering informed decisions in healthcare. Tune into this essential episode now!

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

Join Dr. Mariam Hanna along with expert allergy and immunology specialist Dr. Ana-Maria Copaescu on this episode of The Allergist, as they unravel the intricacies of penicillin allergy, a commonly misunderstood health concern.

On this episode:

• The PALACE Study Breakthrough: How direct oral penicillin challenge is reshaping allergy testing.
• Understanding the PEN-FAST Score: A crucial tool in evaluating the likelihood of penicillin allergy.
• Symptoms and Safety: Understanding the common symptoms of penicillin allergy and associated risks.
• A Closer Look at Fatalities: Debunking fears and highlighting the rarity of severe reactions.
• Safety in Pregnancy: Exploring the findings on the safety of direct oral penicillin challenge in pregnant patients.
• Rethinking Drug Allergy Labels: Dr. Copaescu's perspective on why these labels are not life sentences.
• The Path Forward: The importance of clinical evaluations by an allergy immunologist.

Prepare to have your assumptions challenged and your understanding deepened. This enlightening discussion sheds light on a topic that affects many, yet is often misinterpreted. Tune in now to discover the truths about penicillin allergy with Dr. Hanna and Dr. Copaescu!

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

Join Dr. Mariam Hanna as she delves into the intricate world of immunodeficiency with pediatric immunologist and allergist, Dr. Rae Brager. In a conversation that illuminates the often-overlooked complexities of the immune system, they shed light on the multifaceted nature of immunodeficiencies, from battling infections to immune dysregulation.

On this episode:

• Decoding the spectrum of immunodeficiency: More than just an inability to fight infections.
• The conundrum of diagnosing immunodeficiency in children as many common childhood illnesses are not indicative of a deficiency.
• The critical role of context and clinical acumen in the evaluation of immunodeficiencies.
• Celebrating the leaps in immunology: Newborn screening, gene therapy, and the revolutionary CAR T-cell therapy.
• Busting myths around cord blood banking: Understanding the real need and advocating for cord blood donation.
• Three pivotal takeaways: The complexity and mystery of the immune system, the rarity of true immunodeficiency in common concerns, and the adaptive prowess of our bodily defenses.

Prepare to be enlightened on the marvels and misconceptions of the immune system. Tune in for a masterclass on immunodeficiency with Dr. Hanna and Dr. Brager. Listen now for a dose of wisdom on the body's misunderstood protector!

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

Dive deep into the realm of skin health as Dr. Mariam Hanna sits down with Dr. Vipul Jain to untangle the intricacies of atopic dermatitis, commonly known as eczema, on this installment of "The Allergist." Shed light on the myths, distinguish the reality, and explore the best therapeutic avenues for this prevalent skin condition.

In this episode:

• Unraveling the causes and symptoms of atopic dermatitis.
• The balance between topical steroids and biologics: Weighing the pros and cons.
• Eczema and allergies: Connected, but not as you might think.
• Navigating the promising horizons: JAK inhibitors and monoclonal antibodies.
• Individualized treatment: Crafting the best plan for every eczema patient.

Be equipped with the latest insights and best practices for managing atopic dermatitis. Tune in for your eczema primer!

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

Venture into the heart of anaphylaxis matters as Dr. Mariam Hanna welcomes Dr. Elissa Abrams, a recognized expert on severe allergic reactions. They dispel doubts, dismantle misconceptions, and offer an in-depth understanding of anaphylaxis and its evolving treatments.

In this episode:

    •Clarifying the real dangers of anaphylaxis.

    •Epinephrine: The undeniable champion in allergic emergencies.

    •The truth about antihistamines and steroids. Do they really help?

    •Questioning old reliables: Is Benadryl really our best bet?

    •Biphasic reactions: Getting the facts straight.

    •Anaphylaxis management: When is home anaphylaxis management an option?

Arm yourself with knowledge and prioritize safety when it comes to anaphylaxis. Don't miss these expert revelations. Listen now!

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

As we navigate through peak asthma week, Dr. Mariam Hanna sits down with Dr. Andrew O'Keefe, a renowned allergist and clinical immunologist from St. John's, Newfoundland. Together, they dive deep into the myths and misunderstandings surrounding asthma and the array of medications available.

In this episode:

• Debunking asthma myths. 
• Ensuring the right asthma diagnosis. 
• Reliever meds: Are we overdoing it? 
• The rise and importance of new controller medications, including biologics. 
• Incorporating asthma management into a healthy lifestyle. 

Get ready to breathe easier with these expert insights. Tune in now!

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

Welcome to your allergy lifeline..."The Allergist" podcast.  A show that separates myth from medicine. Deciphering allergies and understanding the immune system.

Hosted by Dr. Mariam Hanna, a pediatric allergist and the Pediatrics Section Advisor for the Canadian Society of Allergy and Clinical Immunology.

Every episode of The Allergist is designed for YOU – the medical professional aiming to stay on the cutting edge of allergy care. We'll clarify, correct, and, most importantly, contextualize the latest evidence.

But it’s not all heavy science here.  We’re bringing humor, stories, and a dash of passion to each topic.

Dive into "The Allergist" podcast, and arm yourself with the knowledge to provide top-notch care to your patients. Together, we’ll ensure you’re always updated, always confident.

Subscribe today.  First episode is out September 26th

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions