IMMUNOLOGY

Immunodeficiency & Complex Immune Care

Helping children and adults with recurrent infections, mast cell disorders, hypermobility-related immune issues, and other complex immune concerns.

At Clearwater Family Medicine & Allergy, we provide detailed immune system evaluations to uncover why you or your child may be getting sick so often or experiencing unexplained reactions. We care for both children and adults, and when needed, we coordinate referral to pediatric academic centers for more advanced or specialized care.

Request an Immunology Evaluation

When to Suspect an Immunodeficiency

Consider an immune evaluation if you or your child experience any of the following:

Frequent ear, sinus, throat, or chest infections
Two or more pneumonias in one year
Repeated courses of antibiotics
Poor response to vaccines
Slow recovery from infections
Persistent thrush or chronic fungal infections
Chronic GI infections or diarrhea
Unusual, severe, or difficult-to-treat infections
Family history of immune problems or primary immunodeficiency

If constant illness has started to feel “normal,” it is time to look deeper.

Conditions We Diagnose and Treat

Antibody Deficiencies

Common Variable Immune Deficiency (CVID)
Selective IgA Deficiency
IgG Subclass Deficiencies
Specific Antibody Deficiency
IgM Deficiency

Combined Immunodeficiencies

SCID (screening and referral)
DiGeorge Syndrome

Phagocytic and Complement Disorders

Chronic Granulomatous Disease (initial evaluation and referral)
Leukocyte Adhesion Deficiency (recognition and referral)
CH50 and AH50 complement pathway abnormalities

Immune Dysregulation Conditions

Autoimmune cytopenias associated with immune dysfunction
Chronic infections with abnormal immune markers
Early autoimmune symptoms suspicious for underlying immune issues

Our Evaluation Process

Your evaluation is tailored to your age, symptoms, and health history. A typical immune workup may include:

Laboratory Testing

Quantitative immunoglobulins (IgG, IgA, IgM, IgE)
IgG subclass testing
Lymphocyte subsets (T, B, and NK cells)
CH50 and AH50 complement testing
Pneumococcal, tetanus, and diphtheria antibody titers
Vaccine challenge testing (Pneumovax when appropriate)
CBC, CMP, ESR, and CRP
Tryptase and other mast-cell markers when indicated
Genetic testing when appropriate

Additional Diagnostic Tools

Spirometry when infections overlap with asthma or lung disease
Food allergy evaluation when reactions or symptoms suggest allergy
Chronic cough assessment
GI or stool testing when recurrent infections or symptoms involve the gut
Coordination with specialty centers for advanced testing when needed

Some children may require referral to pediatric immunology specialists at academic centers if higher-level testing or treatment is needed. We will guide and support that process.

Treatment Options and Ongoing Care

Immunoglobulin Replacement Therapy

For appropriate patients, we evaluate, initiate, and coordinate:

IVIG (intravenous immunoglobulin)
SCIG (subcutaneous immunoglobulin)

Our team assists with prior authorizations and collaborates with infusion centers or home-infusion services as needed.

Infection Prevention Strategies

Prophylactic antibiotics when appropriate
Optimized vaccination schedules
Personalized plans to reduce infection risk at home, school, and work
Guidance around sleep, nutrition, stress, and lifestyle factors that support immune health

Ongoing Monitoring

Regular follow-up visits
Repeat lab monitoring when indicated
Collaboration with hematology, infectious disease, genetics, or other specialists

Recurrent Infection Evaluation

We take a deeper look when you or your child are told “it is just another infection.” We evaluate patients with:

Chronic or recurrent sinusitis
Frequent ear infections
Recurrent bronchitis or pneumonia
Recurrent skin infections
Recurrent GI infections

Why Patients Choose Clearwater Family Medicine & Allergy

Detailed, root-cause approach to immune health
Evaluation for both common and complex immune concerns
Care for both adults and children, with referral support to pediatric academic centers when needed
Integration with allergy, asthma, eczema, sinus disease, and GI care
Clear education and guidance so you know what is happening and why
Telemedicine options available across Florida for appropriate visits

Frequently Asked Questions

Do I need a referral?

In many cases you can schedule directly. Some insurance plans may require a referral; our team can help you check your benefits.

Does insurance cover immunology testing?

Most standard labs and evaluations are covered, but coverage varies by plan. We can review typical testing and help you understand potential costs.

Can children be evaluated?

Yes. We evaluate children for suspected immunodeficiency, and when advanced testing or therapies are needed, we help coordinate referral to pediatric immunology specialists at academic centers.

Do you offer telemedicine?

Yes. For appropriate visits, we offer telemedicine throughout Florida, which can be especially helpful for follow-ups and care coordination.

What is a vaccine challenge test?

A vaccine challenge test is a safe, controlled way to see how your immune system responds to certain vaccines by checking antibody levels before and after vaccination.

Ready to Get Answers About Your Immune Health?

If you or your child are dealing with frequent infections, unexplained reactions, or complex symptoms, an immune evaluation can be an important next step.

Request an Immunology Evaluation

Immunodeficiency & Complex Immune Care

Helping children and adults with recurrent infections, mast cell disorders, hypermobility-related immune issues, and other complex immune concerns.

Request an Immunology Evaluation

When to Suspect an Immunodeficiency

Consider an immune evaluation if you or your child experience any of the following:

Frequent ear, sinus, throat, or chest infections
Two or more pneumonias in one year
Repeated courses of antibiotics
Poor response to vaccines
Slow recovery from infections
Persistent thrush or chronic fungal infections
Chronic GI infections or diarrhea
Unusual, severe, or difficult-to-treat infections
Family history of immune problems or primary immunodeficiency

If constant illness has started to feel “normal,” it is time to look deeper.

Conditions We Diagnose and Treat

Antibody Deficiencies

Common Variable Immune Deficiency (CVID)
Selective IgA Deficiency
IgG Subclass Deficiencies
Specific Antibody Deficiency
IgM Deficiency

Combined Immunodeficiencies

SCID (screening and referral)
DiGeorge Syndrome

Phagocytic and Complement Disorders

Chronic Granulomatous Disease (initial evaluation and referral)
Leukocyte Adhesion Deficiency (recognition and referral)
CH50 and AH50 complement pathway abnormalities

Immune Dysregulation Conditions

Autoimmune cytopenias associated with immune dysfunction
Chronic infections with abnormal immune markers
Early autoimmune symptoms suspicious for underlying immune issues

Our Evaluation Process

Your evaluation is tailored to your age, symptoms, and health history. A typical immune workup may include:

Laboratory Testing

Quantitative immunoglobulins (IgG, IgA, IgM, IgE)
IgG subclass testing
Lymphocyte subsets (T, B, and NK cells)
CH50 and AH50 complement testing
Pneumococcal, tetanus, and diphtheria antibody titers
Vaccine challenge testing (Pneumovax when appropriate)
CBC, CMP, ESR, and CRP
Tryptase and other mast-cell markers when indicated
Genetic testing when appropriate

Additional Diagnostic Tools

Spirometry when infections overlap with asthma or lung disease
Food allergy evaluation when reactions or symptoms suggest allergy
Chronic cough assessment
GI or stool testing when recurrent infections or symptoms involve the gut
Coordination with specialty centers for advanced testing when needed

Some children may require referral to pediatric immunology specialists at academic centers if higher-level testing or treatment is needed. We will guide and support that process.

Medications & Your Immune System Testing

Some medications can temporarily affect your immune system or change your blood test results. Before we order testing, we review everything you take so the results truly reflect how your immune system is working — not what your medications are doing to it.

Please don't stop any medication on your own. Some medications are dangerous to stop suddenly. We will review your medication list with you, decide together which (if any) need to be paused, give you a written timeline, and coordinate with your other doctors when needed.

Medications that can affect immune testing include:

Corticosteroids (such as prednisone), especially at higher doses or for longer periods
Autoimmune disease treatments (such as rituximab, methotrexate, mycophenolate, or azathioprine)
Some seizure medications (phenytoin, carbamazepine, valproate)
Multiple sclerosis treatments (such as fingolimod or ocrelizumab)
Certain cancer therapies (such as ibrutinib or bortezomib)
Immunoglobulin infusions (IVIG or SCIG)

When you schedule, please share a complete list of every medication, supplement, and infusion you take — including any started by other doctors. See the FAQ below for more detail.

Treatment Options and Ongoing Care

Immunoglobulin Replacement Therapy

For appropriate patients, we evaluate, initiate, and coordinate:

IVIG (intravenous immunoglobulin)
SCIG (subcutaneous immunoglobulin)

Our team assists with prior authorizations and collaborates with infusion centers or home-infusion services as needed.

Infection Prevention Strategies

Prophylactic antibiotics when appropriate
Optimized vaccination schedules
Personalized plans to reduce infection risk at home, school, and work
Guidance around sleep, nutrition, stress, and lifestyle factors that support immune health

Ongoing Monitoring

Regular follow-up visits
Repeat lab monitoring when indicated
Collaboration with hematology, infectious disease, genetics, or other specialists

Recurrent Infection Evaluation

We take a deeper look when you or your child are told “it is just another infection.” We evaluate patients with:

Chronic or recurrent sinusitis
Frequent ear infections
Recurrent bronchitis or pneumonia
Recurrent skin infections
Recurrent GI infections

Why Patients Choose Clearwater Family Medicine & Allergy

Detailed, root-cause approach to immune health
Evaluation for both common and complex immune concerns
Care for both adults and children, with referral support to pediatric academic centers when needed
Integration with allergy, asthma, eczema, sinus disease, and GI care
Clear education and guidance so you know what is happening and why
Telemedicine options available across Florida for appropriate visits

Frequently Asked Questions

Do I need a referral?

In many cases you can schedule directly. Some insurance plans may require a referral; our team can help you check your benefits.

Does insurance cover immunology testing?

Most standard labs and evaluations are covered, but coverage varies by plan. We can review typical testing and help you understand potential costs.

Can children be evaluated?

Yes. We evaluate children for suspected immunodeficiency, and when advanced testing or therapies are needed, we help coordinate referral to pediatric immunology specialists at academic centers.

Do you offer telemedicine?

Yes. For appropriate visits, we offer telemedicine throughout Florida, which can be especially helpful for follow-ups and care coordination.

What is a vaccine challenge test?

A vaccine challenge test is a safe, controlled way to see how your immune system responds to certain vaccines by checking antibody levels before and after vaccination.

Why do some medications need to be paused before my immune test?

Many common medications — including steroids, autoimmune treatments, certain seizure medications, and immunoglobulin infusions — can temporarily affect your immune system or your antibody levels. If we don't account for them, the results could look abnormal when nothing is wrong, or hide a real problem. We will tell you which (if any) of your medications need to be paused and how to do it safely.

Which medications might affect my immune test results?

Common ones include corticosteroids (such as prednisone), rituximab and similar autoimmune therapies, methotrexate, mycophenolate, azathioprine, some seizure medicines (phenytoin, carbamazepine, valproate), certain multiple sclerosis treatments (fingolimod, ocrelizumab), and immunoglobulin infusions (IVIG or SCIG). Please share a complete list of every medication, supplement, and infusion you take when you schedule — including those started by other doctors.

I receive IVIG or SCIG infusions. How does that affect my testing?

Immunoglobulin replacement raises your measured antibody levels and adds passive antibodies that aren't your own, so testing during therapy can be misleading. If we need to reassess your immune system while you're on therapy, we coordinate the timing carefully — sometimes a 5–6 month pause is needed for accurate results. Please tell us about any infusions, even those given elsewhere.

Should I stop my medications on my own before the appointment?

No — please don't stop any medication on your own. Some medications are dangerous to stop suddenly. We will review everything you take, decide together which (if any) need to be paused, give you a written timeline, and coordinate with your other doctors when needed.

What if I can't safely stop the medications I'm on?

That's common, and we have options. We can interpret your test results in the context of your medication, focus on tests that aren't affected by immunosuppression, or use targeted genetic testing — which gives accurate results regardless of what you're currently taking.

Ready to Get Answers About Your Immune Health?

If you or your child are dealing with frequent infections, unexplained reactions, or complex symptoms, an immune evaluation can be an important next step.

Request an Immunology Evaluation