The Respiratory Immunology Clinic

The Immunology Clinic at Royal Papworth Hospital attracts regional and national referrals with severe, persistent, unusual, recurrent or relapsing (SPUR) lung infections to assess for immunodeficiency, immune ageing, and impaired immunity responses to immunisation.

The consultant immunologists provide clinical and laboratory support (immunology laboratory) for the Cambridge Centre for Lung Infection within an integrated clinical/pathological/radiological approach. 

The Immunology Clinic and the Lung Defence Clinic run in tandem to provide a uniquely streamlined service covering a wide spectrum of conditions characterised by difficult lung infection. The immunology team works closely with the clinical immunology team at CUH to optimise patient journey when multi-site care is needed.

The Immunology Clinic specialises in investigating and treating patients with:

1. Primary Immunodeficiency

• Classical antibody and cellular immunodeficiencies presenting with infections
• Immunodeficiencies presenting with autoimmune/allergic diseases
• Non-classical immunodeficiencies - narrow spectrum of infection and/or autoimmunity
• Sequelae of primary immunodeficiency presenting in childhood

2. Secondary Immunodeficiency: in the context of treatment for a range of cancers including

• Leukaemia and lymphoma
• Post-bone marrow/ haematopoetic stem cell transplantation (BMT / HSCT)
• Post all cause cancer chemotherapy

3. Secondary Immunodeficiency in the context of treatment for:

• Autoimmune disorders
• GUCH e.g. after surgery for congenital heart disease with incidental thymectomy
• Premature Immune Ageing associated with increasing infection vulnerability

4. Ataxia Telangectasia (AT) in Adults

Immunology Support is provided as part of the National Adult Ataxia Telangiectasia Service delivered at RPH to address the immunological problems these patients face.

Immunoglobulin replacement therapy 

We support more than 100 patients receiving immunoglobulin replacement with Intravenous Immunoglobulin (IVIG) or Subcutaneous Immunoglobulin (SCIG) and biological therapies including Interferon gamma.

Most of our patients opt to be trained to manage their own treatment and receive training in immunoglobulin home therapy on our day ward. They are then supported through protocol driven annual reviews and specialist clinics for:

• Immunoglobulin Infusions – IVIG,  SCIG and manual push injection method as appropriate
• Home Care Therapy Training and nurse led reviews of Immunoglobulin therapy

The Immunology Service structure

Patients may be referred into the immunology service from primary, secondary and tertiary health service providers through written referral. On receipt of referral and triage, we aim for our patients to be seen as soon as possible with first consultation within 6 weeks of referral being received.

The patient will be seen by a consultant immunologist in the first instance. Immune investigations may be made on the day of the clinic visit or a day case appointment made for more comprehensive evaluation prior to ongoing clinic review and treatment implementation.
 

Research

The immunology team actively participate in clinical and translational research both within Cambridge, the UK and internationally to understand the molecular genetic causes of primary immune deficiency and how best to optimise management of complications of primary and secondary immune deficiency. They are part of the National Clinical Immunology Association (UKPIN) and the European Society of Immunodeficiency (ESID).
 

Patient information leaflets

• Lung defence unit telephone support service

Patient Organisations

• UK Primary Immune–deficiency Patient Support 
• The Jeffrey Modell Foundation (JMF)
• AT Society
• British Lung Foundation