Pediatric inpatient consultation of allergy/immunology

There are no studies that examine the referral patterns for allergy/immunology consultation from an inpatient pediatric service. The purpose of this study was to examine the referring diagnosis and/or the requested evaluation on consultations from the inpatient pediatric service to allergy/immunology. We reviewed all inpatient consults submitted to allergy/immunology from 1995 to 1999. We selected consults submitted by the inpatient pediatrics service on patients 18 years of age and younger for further review. There were 350 total inpatient consultations over the 5-year period of which 165 (47%) were from pediatrics. Our results demonstrated that the 58% (96/165) of pediatric inpatient consults were for the evaluation of asthma, 13% (22/165) for immunodeficiency evaluation, 9.7% (16/165) for the evaluation of antibiotic allergy, and 7.9% (13/165) for evaluation of anaphylaxis. The leading reason for immunodeficiency consultation was to "rule-out" DiGeorge's syndrome (6/22). The leading request from antibiotic allergy consultation was to evaluate a history of β-lactam reaction (13/16). The leading reason for an evaluation of anaphylaxis was a reaction to food (5/13). We conclude that pediatric inpatient consultation of the allergy/immunology happens infrequently (<3 per month), but that it is crucial to the evaluation of several uncommon but life-threatening diagnoses.