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Home > Patients and Visitors > Specialties and Services > Rheumatology, Allergy and Immunology

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Overview

The Department of Rheumatology, Allergy and Immunology is a referral centre for patients with rheumatologic and allergic disorders in Singapore and the region, established initially by Prof Feng Pao Hsii in 1979, with Clinical Immunology/Allergy (CIA) added in 1988 upon the return of Prof Chng Hiok Hee from her HMDP Training.

On 1 January 2001, the Department was renamed Department of Rheumatology, Allergy & Immunology (RAI). The Department presently has 13 Senior Consultants, 5 Consultants, 1 Associate Consultants and 4 Senior Residents. They are supported by 3 Clinical Immunology/Allergy and 2 Rheumatology Nurse Clinicians, and 1 Advance Practice Nurse (APN) in Rheumatology.

List of Services

Rheumatologic disorders affect the muscles, bones and joints. Some of these disorders may also affect major organ systems like the kidneys, nerves, heart and lungs.

New patients may be referred to:

  • Consultant's Personal Clinic
    All named or private referrals may be made to any of our consultant rheumatologists.
  • General New Case Clinic
    Referrals for any suspected rheumatic disease.
  • Urgent New Case Clinic
    Referrals that need attention within 1-2 weeks.

Stable patients are internally referred by our rheumatologists for continuing care to the following clinics:

  • Lupus Clinic
  • Rheumatoid Arthritis Clinic
  • Spondyloarthropathy Clinic
  • Psoriatic Arthritis Clinic
  • Connective Tissue Disease Clinic
  • Mixed Connective Tissue Disease/Scleroderma Clinic
  • Gout Clinic
  • Osteoporosis Clinic

    Where appropriate, patients are referred to the following services available within TTSH for further treatment:

    • Disease-specific education programmes/group therapy run by Rheumatology Nurse Clinicians
    • Physiotherapy
    • Occupational therapy
    • Podiatry
    • Orthopaedic surgery
    • Acupuncture service
    • Pain Clinic

This is run by rheumatologists trained in musculoskeletal ultrasonography.

It provides diagnosis and treatment for patients with arthritis and soft tissue rheumatism including ultrasound-guided aspiration of joints, biopsies and injections. ​

Examination of the nailfold capillaries can be diagnostic in patients with certain disorders including Raynaud's phenomenon, systemic sclerosis and dermatomyositis.

This centre provides ancillary outpatient services including:

  • Intravenous cyclophosphamide infusion
  • Infusion of biologic agents for refractory arthritis/spondyloarthritis
  • Infusion of bisphosphates for osteoporosis
  • Minor procedures:
    • Minor salivary gland biopsy
    • Soft tissue and joint aspirations/injections

We evaluate and manage adolescents (above 16 years of age) and adults with the following conditions:

  • Anaphylaxis from any cause
  • Drug allergy (note: the allergy centre does not conduct evaluation of allergies to unknown drugs or substances, and does not conduct screening for potential drug allergies)
  • Food allergy and intolerance
  • Insect venom allergy
  • Primary immunodeficiency diseases
  • Urticaria and angioedema (including assessment and management of Hereditary Angioedema)

New patients may be referred to:

  • Consultant's Personal Clinic
    All named or private referrals may be made to any of our consultant clinical immunologist/allergists
  • CIA New Case Clinic (unnamed referrals)
    • Immunodeficiency Clinic
    • Allergy Clinic
      All referrals are screened by allergist to ensure right siting, and priority is given to urgent cases

The following diagnostic and therapeutic services are available:

  • Skin prick testing for allergens (e.g. food, insect venom, local aeroallergens)
  • Skin prick and intradermal testing for drug allergy
  • Provocation/ challenge tests (e.g. to food, drug)
  • Drug desensitisation where indicated
  • Allergen-specific immunotherapy (for insect venom allergy, allergic rhinitis and asthma)
  • Monthly intravenous immunoglobulin replacement (for antibody deficiency). Education and counselling is provided by the Clinical Immunology/ Allergy Nurse Clinician. These include allergen avoidance, emergency management of anaphylaxis (including epinephrine autoinjector use), use of intranasal steroids, inhalers and skin care for atopic dermatitis.

  • Ankylosing Spondylitis
  • Anaphylaxis
  • Airway allergy, chronic sinusitis and polyposis
  • Anti-phospholipid syndrome (APS)
  • Behcet's Disease
  • Drug Allergy
  • Drug Induced Rheumatic Disorders
  • Food Allergy
  • Gout and crystal arthropathy
  • Henoch-Schönlein Purpura (HSP)
  • Inflammatory Myopathies (eg. Dermatomyositis, Polymyositis)
  • Idiopathic Thrombocytopenic Purpura
  • Immunodeficiency
  • Insect venom allergy
  • Joint hypermobility
  • Miscellaneous allergic and immunologic disorders
  • Osteoarthritis
  • Osteoporosis
  • Psoriatic Arthritis
  • Rheumatoid Arthritis
  • Sarcoidosis
  • Sjogren's syndrome
  • Fibromyalgia
  • Repetitive Strain Syndromes
  • Systemic sclerosis
  • Systemic vasculitides
  • Infectious Arthritis
  • Juvenile Chronic Arthritis
  • Systemic Lupus Erythematosus
  • Urticaria and angioedema














 

Laboratory Services

Find out more on the services provided by the Clinical Immunology Laboratory and Immunology Research Laboratory.

Read More





List of Related Clinics

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