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Allergies and immunology

Coeliac disease: investigation and management

Coeliac disease affects approximately 1 in 100 adults. However, it is often unrecognised as symptoms can be vague and non-specific... View Article

August 2022

Scabies: diagnosis and management

Scabies is a highly contagious skin infestation that can often rapidly spread through households before it is detected. The characteristic... View Article

May 2022

Diagnosing and managing lactose intolerance

Primary lactase deficiency, the main cause of lactose intolerance, is estimated to affect 8% of people in New Zealand, with substantially... View Article

December 2021

Managing cows' milk protein allergy in infants

Dietary avoidance of cows’ milk is the only management strategy for infants with cows’ milk protein allergy (CMPA). If continued... View Article

November 2019

Upfront: Are blood eosinophil counts helpful in predicting patient responses to inhaled corticosteroids in COPD?

The risks and benefits of treatment with inhaled corticosteroids (ICS) are different for individual patients with COPD. There... View Article

March 2016

The New Zealand Laboratory Schedule and Test Guidelines: Immunology Tests

Over the last few editions of Best Tests we have outlined the various sections of the New Zealand Laboratory Schedule. The aim... View Article

July 2015

When is an allergy to an antibiotic really an allergy?

Many patients report allergies to antibiotics but often this will be based on vague symptoms or a historical entry in the clinical... View Article

June 2015

Contact dermatitis: a “working” diagnosis

Contributed by: Dr Lissa Judd, Occupational Dermatologist, Wellington View Article

April 2014

Upfront: Azithromycin: use it wisely

Growing use of azithromycin in New Zealand means that we are in danger of increasing bacterial resistance to macrolide antibiotics,... View Article

April 2014

Biologic medicines for the treatment of inflammatory conditions: What does primary care need to know?

Patients with severe immune-mediated inflammatory diseases, e.g. rheumatoid arthritis, Crohn’s disease or psoriasis, often respond... View Article

December 2013

Assessing wheeze in pre-school children

Wheeze in children aged less than five years has many potential causes. Often it is regarded as the first sign of asthma, however,... View Article

November 2013

Causes, complications and treatment of a red eye

Most cases of “red eye” seen in general practice are likely to be conjunctivitis or a superficial corneal injury, however, red... View Article

August 2013

Diagnosis and treatment of urticaria

Urticaria is a common condition, which is usually non-allergenic, but in the majority of patients a specific cause will not be... View Article

April 2012

Appropriate use of allergy testing in primary care

Most patients with suspected allergy can be adequately managed with medicines, appropriate advice and reassurance, without it... View Article

December 2011

Dietary advice for people with coeliac disease

People with a confirmed diagnosis of coeliac disease must adhere to a life-long gluten-free diet. When first diagnosed, nutritional... View Article

May 2011

Allergy to cows' milk protein and the appropriate use of infant formula

Extensively hydrolysed formula for infants aged under six months and soy formula for infants aged over six months are the first-line... View Article

May 2011

Methotrexate prescribing errors can be fatal

When used and monitored correctly methotrexate can be an effective and safe treatment, however, if an error occurs and it is taken... View Article

February 2011

Investigating the Gut: Coeliac disease

Tissue transglutaminase antibodies are the most useful preliminary step for testing people with a clinical picture suggestive... View Article

March 2010

Investigating the Gut: Inflammatory bowel disease - the role of faecal calprotectin

Clinical assessment of intestinal inflammation can be problematic. Faecal calprotectin can be useful in differentiating between... View Article

March 2010

Investigating the Gut: Lactose intolerance

The role of laboratory tests in diagnosing lactose intolerance in primary care is limited. In most cases the diagnosis can be... View Article

March 2010

Non-occupational exposure to Human Immunodeficiency Virus

Rates of HIV infection are increasing in New Zealand, especially among men who have sex with other men. GPs are often the first... View Article

December 2009

Seasonal allergic rhinitis

Seasonal allergic rhinitis, more commonly known as hay fever, can have a significant impact on quality of life. Asthma often co-exists... View Article

November 2009

TNF inhibitors - an update

Tumour necrosis factor (TNF) inhibitors are used in the treatment of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis,... View Article

November 2009

Managing eczema

Eczema can have a significant impact on the lives of patients and their families. The aims of treatment are to identify and minimise... View Article

September 2009

The treatment of psoriasis in primary care

Psoriasis is an emotionally and physically debilitating disease which can significantly affect quality of life. Support with psychosocial... View Article

September 2009

Scabies - diagnosis and management

Scabies manifests as an itchy skin rash, as a result of an allergic reaction to the female scabies mite. Infection is easily spread... View Article

February 2009

The management of anaphylaxis in primary care

Anaphylaxis is a potentially fatal hypersensitivity reaction, characterised by rapid onset of life-threatening respiratory and... View Article

December 2008

Crohn’s disease and ulcerative colitis

Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases. These conditions are usually managed in... View Article

September 2008

Dietary advice for people with coeliac disease

When people are newly diagnosed with coeliac disease, their nutritional status is often compromised, and they may require repletion... View Article

August 2008

The investigation of coeliac disease: A follow up

Dr Richard Steele provides some clarification on the issue of which tests are most appropriate for investigating coeliac disease... View Article

April 2008

Coeliac Disease

Coeliac disease is a common but often unrecognised disorder, affecting about 1 in 100 people. Symptoms of coeliac disease are... View Article

October 2007

Lactose intolerance

Lactose intolerance affects many adults and children. It is either genetically determined or experienced transiently as a result... View Article

October 2007

Testing for Coeliac disease

Anti-endomysial (EMA) antibody or anti-tissue transglutaminase (TTG) are the best initial tests for detecting coeliac disease,... View Article

March 2007