Evolving Patterns in Inpatient Pediatric Consultations to Allergy/Immunology at an Academic Medical Center

Authors

  • Madeline Wurst Third-year Medical Student. University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA. https://orcid.org/0000-0002-6586-055X
  • Anna Brameli MD. Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Matthew Krantz MD. Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. https://orcid.org/0000-0001-7589-9127
  • R. Stokes Peebles, Jr. MD. Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. https://orcid.org/0000-0002-1429-7875
  • Yasmin Khan MD. Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center/Monroe Carell Children’s Hospital, Nashville, TN, USA.
  • Cosby A. Stone, Jr. MD, MPH. Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. https://orcid.org/0000-0002-1888-4188

DOI:

https://doi.org/10.5195/ijms.2024.2541

Keywords:

consultations, Referrals, allergy, Immunology, immunologic deficiency syndromes, anaphylaxis, angioedema, pediatric, Pediatric Consultations, Allergy/Immunology, Immunodeficiency, Drug Allergy, TREC Screening, Inflammatory Syndromes, Vanderbilt Medical Center, Fellowship Training, Retrospective Study, Pediatric Inpatients

Abstract

Background: Consultations to pediatric allergy/immunology are of benefit to many hospitalized inpatients, but there is limited current information about how T-cell receptor excision circles (TREC) screening may have changed these patterns for pediatric populations. We aimed to determine the types of consults being requested and their relative frequencies for primary pediatric allergy/immunology consults under an academic fellowship program since the start of TREC screening in 2016. Information gained could help identify focal concepts for pediatric allergy inpatient training curricula for fellowship and graduate medical education programs.

 Methods: Under an IRB approved study of an academic allergy fellowship consultation log, we retrospectively reviewed electronic medical records of pediatric allergy and immunology consults and categorized consultations by their primary indication. 

 

Results: Three-hundred and eighty-three pediatric allergy/immunology consultations were seen between September 4, 2016 to November 24, 2022.  In terms of frequency, the most common consultation was for immunodeficiency evaluation or treatment, n=205 (53.5%), followed by drug allergy n=55 (14.4%), general allergy concerns n=43 (11.2%), skin allergy n=35 (9.1%), and less commonly inflammatory syndromes, n=26 (6.8%) and food allergy, n=19 (5.0%).  Questions related to TREC screening comprised 21% of all immunodeficiency consults, at n=43.

Conclusion: At an academic allergy center where all allergy/immunology service lines are currently provided, the most common reason for pediatric consultations were for help with immunodeficiency evaluation/treatment and drug allergy. TREC screening is a new key indication for consultation. Fellowship programs may benefit from focusing on these content areas for the pediatric inpatient setting.

 

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References

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The graph titled "Number of Category and T-cell receptor excision circles (TREC) Consults per Year" shows the annual number of pediatric allergy and immunology consultations from 2016 to 2022. Immunodeficiency consults (yellow line) are the most frequent and show a steady rise, peaking in 2021. TREC-related consults (blue line), linked to immunodeficiency screening in newborns, also increased notably starting in 2016. Other categories, such as drug allergies, general allergies, and inflammatory syndromes, show less variation but maintain a consistent presence over the years​.

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Published

2024-09-30

How to Cite

Madeline Wurst, Anna Brameli, Matthew Krantz, Peebles, Jr., R. S., Yasmin Khan, & Stone, Jr., C. A. (2024). Evolving Patterns in Inpatient Pediatric Consultations to Allergy/Immunology at an Academic Medical Center. International Journal of Medical Students, 12(3), 278–283. https://doi.org/10.5195/ijms.2024.2541

Issue

Vol. 12 No. 3 (2024)

Section

Short Communication

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Copyright (c) 2024 Madeline Wurst, Anna Brameli, Matthew Krantz, R. Stokes Peebles, Jr., Yasmin Khan, Cosby Stone, Jr.

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