Rheumatology, Allergy and Immunology

We evaluate and manage patients aged 18 and above with a wide range of rheumatologic, autoimmune and autoinflammatory conditions such as rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, Sjogren’s syndrome, antiphospholipid syndrome, systemic sclerosis, autoimmune myositis, systemic vasculitis, and adult-onset Still’s disease.

Our doctors specialise in diagnosing and treating a wide range of musculoskeletal diseases, systemic autoimmune conditions, and autoinflammatory disorders. These include:

• Adult-onset Still’s disease
• Amyloidosis
• Ankylosing spondylitis
• Anti-phospholipid syndrome
• Autoimmune myositis
• Autoimmune vasculitis (including giant cell arteritis, Takayasu’s arteritis, ANCA-associated vasculitis, Behçet’s disease, polyarteritis nodosa, and cryoglobulinaemia)
• Crystal arthropathies (e.g. complicated gout, pseudogout)
• Enteropathic spondyloarthritis
• Polymyalgia rheumatica
• Psoriatic arthritis
• Rheumatoid arthritis
• Sarcoidosis
• Seronegative spondyloarthropathy
• Sjögren’s syndrome
• Soft tissue rheumatism
• Systemic IgG4-related disease
• Systemic lupus erythematosus
• Systemic sclerosis

All patients seen in our department are assigned to a primary specialist for dedicated care and management. Named referrals can also be made as private referrals to any of our consultant rheumatologists. Besides face-to-face consultations, telemedicine or video consultations may be offered to stable long-term follow-up patients on a case-by-case basis. We also offer the following sub-specialty clinics to provide more dedicated and optimal care for patients with specific medical conditions:

• Early arthritis clinic
• Systemic sclerosis clinic
• Autoimmune myositis clinic
• Psoriatic arthritis clinic
  

We evaluate and manage adolescents (above 18 years of age) and adults with conditions such as anaphylaxis, allergy to drugs/food/insect venom, urticaria and angioedema, and inborn errors of immunity (IEI, which used to be known as primary immunodeficiency).

Our doctors specialise in diagnosing and treating various allergic and immunologic disorders. These include:

• Anaphylaxis from any cause
• Drug allergy
  Note: our centre does not evaluate allergies to unknown drugs or substances and does not conduct screening for potential drug or substance allergies
• Food allergy and intolerance
• Idiopathic urticaria and angioedema (including assessment and management of Hereditary Angioedema)
• Inborn errors of immunity (used to be known as Primary immunodeficiency diseases)
• Insect venom allergy

All patients seen in our department are assigned to a primary specialist for dedicated care and management. Named referrals can also be made as private referrals to our consultants. Besides face-to-face consultations, telemedicine or video consultations may be offered to stable long-term follow-up patients on a case-by-case basis. We also offer the following sub-specialty clinics to provide more dedicated and optimal care for patients with specific medical conditions:

• Immunodeficiency
• Urticaria and angioedema

The Clinical Immunology/Allergy Nurse Clinicians provide education and counselling. These include allergen avoidance, emergency management of anaphylaxis (including epinephrine autoinjector use), use of intranasal steroids and inhalers, and skin care for atopic dermatitis.

We conduct diagnostic tests and treatment for various allergic and rheumatologic conditions at our Day Treatment Centre when clinically indicated.

Diagnostic tests and treatment for various allergic and rheumatologic conditions are performed at our Day Treatment Centre where appropriate. These include:

• Allergen-specific immunotherapy (for insect venom allergy, allergic rhinitis and asthma)
• Drug desensitisation where indicated
• Provocation/challenge tests (e.g. to food, drug)
• Skin prick and intradermal testing for drug allergy
• Skin prick testing for allergens (e.g. food, insect venom, local aeroallergens)
• Minor salivary gland biopsy (for patients with suspected Sjögren’s syndrome)
• Infusion treatment for osteoporosis (i.e. intravenous zoledronic acid)
• Infusion treatment for rheumatologic conditions (e.g. intravenous cyclophosphamide, infliximab, tocilizumab)

Monthly intravenous immunoglobulin replacement (for antibody deficiency) is performed at our hospital’s Medical Ambulatory Centre.

We perform rheumatologic ultrasound and nailfold capillaroscopy to diagnose various rheumatologic conditions when clinically indicated.

We have a team of doctors trained in performing rheumatologic ultrasound and nailfold capillaroscopy to aid in diagnosing various rheumatologic conditions.

Rheumatologic ultrasound uses real-time imaging of the affected joints and surrounding soft tissues to diagnose and treat patients with arthritis and soft tissue rheumatism. When appropriate, ultrasound-guided aspiration of joints, biopsies, and injections may be performed. We also perform ultrasound examinations of the salivary glands, cranial arteries, major vessels, lungs and skin, where additional information from the examination may help diagnose or manage the rheumatologic conditions.

Nailfold capillaroscopy helps diagnose patients with certain disorders, including Raynaud's phenomenon, systemic sclerosis and autoimmune myositis, by looking for abnormal blood vessels at the nailbeds.

We have a team of nurses and a pharmacist specialising in treating patients with rheumatologic, allergic, and immunologic conditions.

We have a team of nurses (including two Nurse Clinicians and two Advanced Practice Nurses) and a pharmacist qualified to provide specialised dedicated care to the group of patients with rheumatologic, allergic and immunologic conditions we serve. The services provided include:

• Rheumatology
• Disease/therapy-specific education and counselling
• Perform Schirmer’s test for patients with suspected Sjögren’s syndrome
• Routine review of arthritis and gout patients in Advanced Practice Nurse and Pharmacist-led clinics
• Clinical immunology and allergy
• Disease/therapy-specific education and counselling
• Performing various allergy tests in the Day Treatment Centre