Dr Jan Sinclair
Paediatric Allergist
Qualifications
MB ChB 1988 Auckland; FRACP 1996
Title or Designation
Paediatric Allergist
Full NZ Registration Date
5 December 1988
Vocational Scope
Paediatrics
I have been seeing patients in private practice in Auckland since 2000 and have been based at the 188 Specialists Centre ( EastMed clinic) since 2007. My initial training was in paediatrics, then further specialising in allergy and clinical immunology. I am happy to see infants, children and young people up until the age at which they finish school.
Common conditions referred for my assessment include:
• Food allergy and intolerance
• Eczema
• Allergic rhinitis
• Asthma
• Recurrent infection
• Urticaria
• Anaphylaxis.
Investigations and treatment may include:
• Allergy skin prick tests
• Blood tests (including “RAST” or specific IgE tests)
• Dietary modification
• Prescription of low allergy formula
• Allergen avoidance protocols
• Desensitisation (generally sublingual or SLIT rather than injection)
• Dietitian referral
• Provision of allergic reaction plans.
Food allergy is a common problem, affecting up to 5% of children. Many food allergic reactions in children are mild and many children outgrow their food allergies with time. A small range of foods are responsible for most food allergic reactions some of which have a good chance of going away with time (e.g. milk, egg, wheat, soy) and some of which are more likely to persist into adulthood (e.g. peanut/nut and fish/shellfish).
Food allergic reactions can cause a variety of signs and symptoms, including:
• Skin – rash, itching, redness, swelling
• Gut – tummy pain, vomiting, diarrhoea
• Respiratory tract – runny nose, sneezing, shortness of breath, cough, wheeze
• Cardiovascular system – faintness, collapse.
A severe food allergic reaction or anaphylaxis will result in difficult/noisy breathing, swelling of tongue, swelling/tightness in throat, difficulty talking/hoarse voice, wheeze or persistent cough, dizziness (loss of consciousness and/or collapse), and becoming pale and floppy in young children. Anaphylaxis is a medical emergency – an anaphylaxis plan should be followed if there is one available and an ambulance called.
Most often the cause of a food allergic reaction is apparent as there is prompt reaction after ingestion of a new food. Allergy tests (skin tests or blood tests for specific IgE) will generally be done to confirm the cause of a food allergic reaction. Ongoing management involves avoidance of the food in question, with follow up to determine whether an allergy has resolved. All patients with food allergy should have a plan for management of any further reactions. In the longer term food challenge may be needed to determine if a food allergy has resolved.
Clinics are held all day Tuesday.
To Make an Appointment
If you would like to make an appointment for your child to see me please telephone the clinic on (09) 585 0190.
Before the Appointment
You will be asked to complete a questionnaire about your child which should be emailed, faxed or posted back to the clinic prior to your appointment.
If allergy tests are likely it is best if your child is not given any antihistamines for 5 days prior to the appointment, as this would interfere with allergy tests. If stopping antihistamines is not possible then you should still keep the appointment, as there are other options to doing skin tests. Other medications (especially for asthma and ezcema) should be continued as usual.
Referral
Appointments can be made with or without referral from your doctor. If your doctor does suggest the appointment it is useful to have a letter from them containing any important information and results of any previous tests.
What to Bring
Please bring your questionnaire and doctor’s referral letter if these have not already been sent to the clinic. Copies of previous allergy test results should be brought with you. Bring your child’s well child book, plus any previous measurements of their height and weight (particularly if there are concerns about growth).
Your Consultation
A child’s first visit may take anywhere from 30 to 60 minutes. If allergy skin testing is needed it will usually be undertaken during this time. If allergy skin testing is needed for unusual allergens then this testing may need to be referred to the hospital lab, and generally an appointment can be made for this within 1-2 weeks.