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Nature of the work

Immunology is a relatively new specialty. It combines caring for patients with immunodeficiency allergy and systemic autoimmune disease with exciting advances in science.

Working in immunology

Immunology involves diagnosing and managing patients with disordered immunological mechanisms. In the UK, immunologists provide clinical and laboratory services for patients with immunodeficiency, autoimmune disease, systemic vasculitis and allergy.

Clinical immunology has evolved from being mainly laboratory based, to a combined clinical and laboratory specialty. The clinical work of immunologists is largely outpatient based and involves:

  • primary immunodeficiency
  • allergy
  • autoimmune rheumatic disease and systemic vasculitis
  • joint paediatric clinics for children with immunodeficiency
  • immunoglobulin infusion clinics for patients with antibody deficiency.

On the laboratory front, consultant immunologists are responsible for directing diagnostic immunology services and perform a wide range of duties including: 

  • clinical liaison
  • interpretation and validation of results
  • quality assurance and assay development.

A minority of immunologists (less than ten percent) also provide laboratory support for transplantation, histocompatibility leukocyte antigen (HLA) and tissue typing.

As awareness of immunological disease has increased, the need for consultant immunologists in the NHS has steadily grown. The specialty currently has approximately 60 consultants with 35 trainees. Consultant expansion has occurred at the rate of one to two new posts annually in addition to replacement appointments. The demands of patients with immunodeficiency, allergy and autoimmune disease, and the need of hospitals to have consultant supervision of immunology laboratories, is likely to ensure that even more consultants will be needed in the foreseeable future.

Common procedures / interventions

Immunologists use a range of immune-mediated therapies, ranging from intravenous immunoglobulin for antibody replacement and immunomodulation, to emerging monoclonal antibody therapies such as Rituximab, which is used in the treatment of some lymphomas.

Associated subspecialties

None applicable.

Further information

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