The Immunology Service

The Immunology Service at Nottingham University Hospitals is based at QMC (Queens Medical Centre) campus and investigates and manages patients’ immunodeficiency and periodic fever/auto-inflammatory conditions. We are also involved in the pilot study of new-born screening for SCID (Severe Combined Immunodeficiency).

We are a regional centre for adults with primary immunodeficiency. The regional catchment areas mainly include Nottinghamshire and Derbyshire, but we also see patients from Lincolnshire and Leicestershire.

Clinics

Adult out-patient Immunology clinics are held in Clinic 2 at QMC Campus

Children’s Immunology out-patient clinics are held in the children’s clinics on East block and South block in the NUH Children’s Hospital, once a week

Referrals

Patients are seen in the Immunology clinic following a referral by a GP, other doctor or specialist e.g. a respiratory doctor or gastroenterologist.

To be seen in a children’s Immunology clinic, a child must be referred by another hospital doctor such as a general paediatrician or specialist.

For internal referrals with in the Trust, a referral form on CareFlow named ‘Clinical Immunology and Allergy – Request for outpatient review’ is available in the orders section.

Adults or children should be referred to an Immunology clinic if primary immune deficiency (an immunodeficiency that is not due to other causes such as medications and lymphoma) or periodic fever/auto-inflammatory condition is suspected.

Signs of primary immune deficiency include:

4 or more new ear infections in a year
2 or more serious sinus infections in a year
2 or more pneumonias (serious chest infections) within a year
2 or more months on antibiotics without getting better
Failure of a baby to grow or gain weight normally
Recurrent deep skin or organ abscesses
Persistent thrush in the mouth or fungal infection of the skin
The need for intravenous antibiotics to clear infections
2 or more deep-seated infections including septicaemia (blood borne infection)
A family history of primary immune deficiency

Signs of periodic fever/auto-inflammatory conditions include:

Unexplained fevers without infection
Rashes
Swollen lymph nodes
Chest pain
Abdominal pain
Conjunctivitis
Hearing loss
A diagnosis of amyloidosis

Preparing for your clinical appointment

It is very important that you read the instructions in your appointment letter

When you come to your appointment, please bring:

Your appointment letter.
A list of your medications, including how much you take and how often.
Glasses or hearing aids that you use.
Your up to date mobile phone number (if you wish to receive text reminders in the future).

If you are a carer, or assisting a patient with dementia, please tell reception when you arrive.

Getting to your appointment

Parking is limited at our hospitals. Please use public transport if you can.

The Medilink bus stops at the 'Park and Ride' at Queens Drive or Wilkinson Street and drops off at the QMC and City Hospital. Many local bus services stop at QMC and City Hospital. There is a small charge for this service.

The tram stops at QMC. You can use the tram if you are coming from the city centre. Other areas along the tram routes include Beeston, Chilwell, Hucknall and Hyson Green.

We have a very limited number of Blue Badge (disabled) parking spaces at each site.

You can find out more information about getting to our hospitals (including maps) by clicking Getting Here in our main menu.

Finding the clinic

Clinic 2 is on the Central route on B Floor in between the X-ray department and the Tram bridge exit.

The children’s clinic South and Children’s Clinic East (Children’s Outpatients) are both on B Floor on the central route between East and South Block

A map of B Floor is available in the Getting Here section.

If you are unable to find the clinic please ask a member of staff or volunteer for directions

Arranging medical transport

If a medical condition prevents you from using public or private transport, please ring the following non-emergency transport providers a few days before your appointment:

If you are registered with a GP in:

Nottinghamshire – call Arriva Transport Solutions on: 0345 266 9662
Derbyshire – call EMAS on: 0300 300 3434
Leicester, Leicestershire and Rutland - call Thames Ambulance Service on: 0345 241 3012
Lincolnshire – call Thames Ambulance Service on: 0808 164 4586
North and North East Lincolnshire – call Thames Ambulance Service on: 0808 164 3030

Changing your appointment

If this is your first appointment in the Immunology department and you need to cancel or change your appointment, you will need to contact us on: 0115 849 3392

If you do change this appointment, it might not be possible to change this again and you may be referred back to your GP.

If you need to change the time or date of a follow-up appointment with us for the same condition please telephone the department secretaries on: 0115 970 9130

What to expect at your appointment

When you arrive for your appointment at clinic please check in at the reception and take a seat

Shortly after your arrival you will be called by one of the clinic staff who may ask to weigh you (or your child) before directing you to an area where you can wait to be seen

At your appointment you may be seen by a consultant, a registrar (experienced junior doctor) or nurse specialists. All staff are trained and experienced in carrying out consultations.

The doctor or nurse will ask you questions about your symptoms and any about your medical history. If needed a blood test may be carried out at the blood taking room/ phlebotomy.

Diagnosis

It is sometimes possible to make an Immunology diagnosis during the first clinic appointment but often it is necessary to wait for blood test results and/or to refer you on for more testing.

Immunoglobulin Replacement

Immunoglobulin replacement involves injection of antibodies purified from blood donations with an aim to improve the levels of those with low levels. This is to help prevent recurrent and serious infections in these individuals.

Adult Immunology patients requiring immunoglobulin replacement can receive this in a number of ways.

Intravenous infusions of immunoglobulin are usually given 2-4 weekly in the Treatment Centre Day Case Unit, QMC Campus (adults). Children who need immunoglobulin replacement therapy are seen on children’s medical day case unit on D floor, at NUH Children’s Hospital.

Subcutaneous immunoglobulin infusions (into the skin) may be possible following assessment of suitability and patients can receive training in order to give their immunoglobulin treatment at home.