Texas Allergy

CLINIC FOR ALLERGY ASTHMA SINUS
AND IMMUNOLOGY DISEASES



Phone: (281)-886-7440
Email: info@texasallergygroup.com

 

Board Certified Adult and Children Allergist and Immunologist

 

Your Health And Wellnes Is Our Priority.

Helping Our Patients Live Free from Allergies, Asthma, and Sinus Diseases Is Our Goal.

 

  • Constant Tiredness, Headache, Eye Itchiness, and Stuffiness?
  • Come For a Visit to Discuss How We Could Help Relieve Your Allergy Symptoms
  • We have 3 convenient locations close to major freeways with easy access and free parking in the Medical Center,  Northwest Houston, and Southwest Houston

Texas Allergy | Houston Allergist | Texas Allergy Group

Services & Procedures

 



We are committed to provide a comprehensive, professional, and patient-focused care in the field of allergy & immunology with the goal is to improve patients' quality of life. Our board-certified allergist & immunologist specialists offer a wide variety of advanced specialty care in diagnosing and treatment of allergy related diseases and diseases of the immune system.

Below are services, procedures and specialty clinics we offer at Texas Allergy, Clinic for Allergy Asthma Sinus and Immunology Diseases.

  1. Allergy Skin Test
  2. Allergy Shot
  3. Allergy Drop and Allergy Tablet
  4. Patch Test
  5. Lung Function Test
  6. FeNO (Fractional Exhaled Nitrite Oxide) Measurement
  7. Oral Food and Oral Drug Challenge
  8. Penicillin Allergy Testing
  9. Local Anesthetic Allergy Testing
  10. Drug Desensitization
  11. Aspirin Desensitization
  12. Insect Allergy Desensitization
  13. Sinus CT Imaging
  14. Rhinoscopy
  15. Xolair® Injection
  16. Other Biologic Monoclonal Antibodies: CinQair®, Nucala® Injection
  17. Immunoglobulin Replacement Therapy

Specialty Clinics

Allergy Skin Test

  • You should avoid all OTC cold/flu or allergy medications one week or at least 5 days before allergy skin testing to avoid interfering with the test.
  • For a complete list of medications to avoid, please click here.
Skin Allergy Test | Texas Allergy | Houston Allergist | Texas Allergy Group

Allergy skin test is used to detect if you are sensitized to or allergic to certain allergens so your physician can formulate an effective treatment to your allergy / sinus, asthma, and other allergy related diseases. At our clinic, we test for common regional environmental allergens including pollens, grasses, weeds, molds, and indoor allergens like cats, dogs, dustmites, cockroach, and rodent. In general, you would exposure to high tree pollen concentration in the Spring, grass and weed pollen in the Summer and Fall. Mold spores and indoor allergens like cat / dog / dustmites are all year-round allergens. Depending on indications, we also test for foods, insects, drugs and other allergens. Skin test is done by pricking the skin in the back or forearm with a small plastic device containing specific allergens to challenge allergy cells living in your skin. The prick site will develop a small mosquito-like wheel if you are allergic to that allergen. Sometimes, your physician might proceed with a second intradermal allergy test if the first test is negative. In this type of test, a small amount of allergen is injected into your skin to increase sensitivity of the test.

For more information, please visit the American College of Allergy Asthma & Immunology - Allergy Test.

Click here to see an illustration of the allergy test or skin test procedure.

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Allergy Shots

 Allergy Shots | Texas Allergy | Houston Allergist | Texas Allergy Group
  • The only true long-term treatment to relief allergy and allergy-related diseases that can last even after completing treatment.

Allergen specific immunotherapy or commonly known as allergy shots is the only true long term treatment to relief your allergy and allergy related diseases that can last even after completing a shot program. It is done by gradually introduce allergens that you are allergic to under the skin to induce tolerance to those particular allergens. It works in 80-85% cases of pollen allergy and significantly decreases allergy symptoms compared to taking medications alone. It also prevents the fluctuation of symptoms seen during allergy seasons and even prevents you from developing new allergy while taking the shots. Build up phase takes about 3 - 6 months. During this time, you are given increasing amount of allergens to reach an effective dose. Maintenance phase takes 3 to 5 years. It might take up to a year to see a significant change in allergy symptoms. There is a small risk of developing anaphylaxis to allergy shots. That is why you are required to stay in the clinic for at least 20 - 30 minutes after getting the shots.

Allergy shots have been done safely as a cost-effective methods to treat and prevent complications from allergic diseases for over 100 years since it was first introduced by British physician Leonard Noon in 1911.

For more information, please visit the American College of Allergy Asthma & Immunology - Allergy Shots.

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Allergy Drops & Allergy Tablets

Allergy drops are off-label use form of allergen specific immunotherapy for many years. It is an effective allergy treatment for certain type of environmental allergy. However there are not much studies to show a standardized approach to this technique. Therefore the desensitization efficacy of several allergens are unknown as well as the consensus on treatment duration. Recently, the FDA has approved 2 types of allergy tablets for patients with Ragweed and Timothy grass allergy. Both allergy drops & allergy tablets carry a lower risk of getting anaphylaxis than allergy shots but they are only available for limited allergens.

For more information, please visit the American College of Allergy Asthma & Immunology - Sublingual Immunotherapy.

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Patch Test

Patch Test | Texas Allergy | Houston Allergist | Texas Allergy Group

Patch testing is a form of allergy testing to detect a second form of allergy that is mediated by immune cells but not by antibodies like in previous tests. It takes several days for the immune cells to recognize and develop reactions to the allergens so when you have the test done, you will have a patch containing allergens of interest applied to your back for 48 hours. The reaction on the skin is read at 48 and 72 hours. Patch test is used to help diagnose allergic contact dermatitis, certain types of food allergy and drug allergy. Many of the patch test are not standardized and required careful interpretation of the results. For more information, please come for a discussion on this topic.

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Lung Function Test Lung Function Test | PFT | Texas Allergy | Houston Allergist | Texas Allergy Group

Lung function test is used to see how well your lung work by looking at how much air volume it can hold and how fast you can move air out of your lung. It is used to diagnose several types of lung diseases including asthma, the severity of it so effective medication doses and strength could be used. It is also used to monitor how well the current treatment is so appropriate and timely treatment adjustment can be made. It takes only a few minutes to do the test. Sometimes, your physician may proceed to ask you do a second lung function test after giving you an albuterol or bronchodilatator inhaler to help diagnose and differentiate different types of lung diseases.

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FeNO Measurement

(Fractional Exhaled Nitrite Oxide)

Higer than normal nitrite oxide level is released in several inflammatory processes including asthma. It is seen in asthmatic conditions that have eosinophilic proliferation. Thus, it is used as a surogate marker for active eosinophilic inflammation in the airway. Those conditions would normally reponse to inhaled steroid and other biologic agents. FeNO measurement is an important tool added-on to peak flow and lung function test to mornitor the progess of asthma, its responsiveness to medications and also in the diagnosis of asthma itself. 

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Oral Food and Oral Drug Challenge

Oral Food/Drug Challenge | Texas Allergy | Houston Allergist | Texas Allergy Group

Oral food and drug challenge are used as an ultimate method to rule out the food or drug allergy in question. Oral challenge is not done for diagnosis purpose. It is indicated when all other tests have been done showing a low risk of developing a clinical reaction to that particular food or drug. It should be done in a supervised environment since there are still risks of having an adverse reaction or even anaphylaxis during the challenge. During the process, you would ingest a small amount of the food or drugs in questions with progressive increase of the dose over time. At the same time, your nurse and physician would continuously monitor you for any early signs of allergic reactions. You would expect to spend half a day in the allergy clinic for this procedure.

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Penicillin Allergy Testing Penicillin Allergy | Texas Allergy Group | Houston Allergist

Penicillin family of medication is an important class of antibiotic. It is also the most common reported allergic drug. However, up to about 90% of self reported childhood penicillin allergy does not have allergy after undergoing testing and drug challenge. Such patients can tolerate this class of medication. Fortunately, commercial available Penicillin skin testing can detect up to 85 - 95% of true allergy cases. After passing a penicillin testing, patient is put to an oral penicillin challenge. Because of the risk of having anaphylaxis during testing and oral challenge, it should be done in an allergy clinic where the physicians and staff have special skill in recognizing and treating allergic reactions.

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Local Anesthetic Allergy Testing Lidocaine and Other Local Anesthetic Allergy | Texas Allergy Group | Houston Allergist

Local anesthetic has been used to provide anesthesia or local numbing and pain relief since the 19th century since the discovery of cocaine. Those can be used topically like in some topical pain relief creams, pastes or patches, as a local nerve block in minor surgeries or dental procedures. There are two distinct types of reactions to local anesthesia: (1) Allergic contact dermatitis, or (2) Urticaria and anaphylaxis. Allergy to local anesthetics can be due to the ester or amide group. They can be safety tested and challenged in an allergy clinic where trained physicians and staff with special skills in diagnosing and treating this condition can mornitor and treat your reactions. Common local anesthetics are (1) Amides: Lidocaine, Bupivacaine, Mepivacaine, Prilocaine... (2) Esters: Butacaine, Benzocaine, Tetracaine, Procaine, Chlorprocaine, Propoxycaine...

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Drug Desensitization Drug Desensitization | Texas Allergy | Houston Allergist | Texas Allergy Group

In some patients who have drug allergy, it is possible that such medications can be used if there is an absolute need for it. In these situations, patients have to go through a drug desensitization process. Drug desensitization is a process of inducing temporary unresponsiveness to the allergic drug. It is done by introducing small amounts of the allergic drug with increasing dose over a fixed time interval until a full therapeutic dose is obtained. This process is used to prevent patients from developing anaphylaxis for the drug in question. It is only a temporary measure and does not induce tolerance for life. The process carries a high risk of severe anaphylaxis so it is done in a hospital ICU unit where close supervision is needed. Common medications that are needed for desensitization are aspirin, antibiotics, biologic drugs e.g. Enbrel®, Humira®, Remicade®, Rituxan®... that are used in several rheumatologic diseases.

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Aspirin Desensitization Aspirin Desensitization | Texas Allergy | Houston Allergist | Texas Allergy Group

Aspirin desensitization is the most effective method of treating AERD or aspirin / NSAID sensitivity. It is indicated in patients with recurrent nasal polyps, hard to control asthma who also have aspirin sensitivity. Desensitization process can be done safely in an outpatient setting. In patients with history of severe reactions or severe asthma, admission to the hospital for desensitization may be needed. The process involves taking a small amount of aspirin with increasing doses over several hours until a desired dose is reached. During this time, you will be closely monitored for any signs of reaction and your lung function is also monitored so you will be quickly treated to reverse any signs of reaction. After this first day of desensitization process, you are required to take aspirin every day to maintain your tolerance to relieve symptoms due to aspirin sensitization. There is a risk of GI bleeding with daily aspirin and it is dosed dependent. Your physicians will discuss with you in details about the risks and benefits of this procedure. The majority of patients with AERD who undergo desensitization will experience a significant improvement of asthma symptoms with less flare ups, less medications use, improvement of sense of smell and taste, and undergo fewer nasal polyps surgeries due to delayed polyps growth. For more information about this topic, please visit the Brigham and Women's Hospital website.

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Insect Allergy Desensitization Insect Allergy Desensitization | Texas Allergy | Houston Allergist | Texas Allergy Group

Insect allergy desensitization is indicated when there is evidence of anaphylaxis after getting insect sting and confirmed by allergy testing. Similar to allergy shots, it is done by gradually introduce small amount of insect venoms underneath the skin gradually over time. By doing this, it would induce tolerance to the allergic stinging insect so you would not develop another systemic and dangerous reaction if got stung again. After finishing the shot program for 3-5 years, you are usually protected for life.

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Sinus CT Imaging

Sinus CT Imaging | Texas Allergy | Houston Allergist | Texas Allergy Group

Sinus CT imaging is a helpful tool in aiding with the diagnosis and treatment of sinus diseases. Sinus CT scan looks at the naso-sinus structure, inflammation, and fluids in the sinuses. Our convenient onsite imaging facility would help facilitate seamless care in allergy and sinus diseases and to provide the best experience for you and your family.

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Rhinoscopy

Rhinoscopy uses a thin flexible fiberoptic cable to enable direct viewing of the nasal passage, sinuses, septum, vocal cord, the larynx and nearby structures to diagnose recurrent, resistant sinus infection, nasal polyps, other structural defects. It can be used to drain the sinuses, dispense antibiotics, and remove polyps from the nose, throat, and vocal cords. It is often used by ear, nose, and throat physician and some allergist. Currently, we do not offer this procedure at our facility.

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Xolair® Injection

Xolair Injection | Texas Allergy | Houston Allergist | Texas Allergy Group

Xolair® is a propriety name of omalizumab, a humanized monoclonal antibody that is engineered to bind to IgE, an allergic antibody, thus, decreases overall allergic reaction in the body. It is approved by the FDA since 2003 to use in patient 12 years and older with moderate to severe asthma who has failed conventional treatment. Recently in March 2014, it is approved for treating patients with recalcitrant chronic urticaria who continue to have hives despite being treated with several other conventional medications. For more information, please visit the official Xolair® website.

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Other Biologics

Monoclonal Antibodies

Nacala | Texas Allergy Group | Houston Allergist

Nucala® (mepolizumab) and CinQair® (reslizumab) are approved by the FDA in November 2015 for the treatment of severe asthma and in patients with history of severe asthmatic attacks who are 12 years and older. According to the CDC, there are more than 2 millions of asthmatics in the US with more than 400,000 hospitalization due to severe asthma a year. Mepolizumab or reslizumab are also humanized monoclonal antibodies like omalizumab or Xolair®, which has been used successfully in severe cases of asthma like in patients who are on several asthma inhalers and still need several hospitalizations for asthma exacerbations. It binds to and blocks the activity of IL-5, an interleukin or cellular signal that stimulates the growth of eosinophil thus decreasing the number of eosinophil in tissues. Overpopulation of eosinophil has been seen in several diseases including asthma, atopic dermatitis, eosinophilic esophagitis, nasal polyposis, hypereosinophylic syndrome, Churg-Strauss syndrome, and COPD. For more information, please visit the official Nucala® or CinQair® website . 

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Immunoglobulin Replacement Therapy

Immunoglobulins
Immunoglobulin or antibody replacement therapy is indicated for use in several conditions of antibody deficiency, a form of
primary immunodeficiency that can cause chronic recurrent sinusitis, bronchitis and severe bacterial infections like pneumonia, deep-seated abscesses, osteomyelitis... It is a blood product taken from plasma pooling from about 10,000 - 50,000 healthy donors. Different products are supplied by different pharmaceutical companies that are slightly different but would work the same way of preventing infections. Your immunologist would choose one that is suitable for you. Replacement can be given either through monthly infusion which requires going to an infusion facility or subcutaneous route which can be done at home weekly, biweekly or monthly with a new formulary. For more information, please visit this topic at the Immune Deficiency Foundation.

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