The Pediatric Allergy polyclinic serves patients in diagnosis and treatment of all allergic diseases, including asthma, exercise-induced asthma, asthma presenting only with coughing, allergic rhinitis (allergic flu), urticaria (rash) and angioedema, atopic dermatitis (eczema), food allergy, drug allergy, venom (bee) allergy, mastocytosis, recurrent wheezing and chronic cough.
The department consists of polyclinic rooms, an allergy test room for skin, drug and food provocation (loading) tests and a respiratory laboratory for respiratory function tests as well as bronchial and exercise provocation tests. Higher-risk patients requiring closer observation are admitted to the pediatric inpatient ward or pediatric intensive care unit, where food/drug loading tests or drug desensitization procedures can be performed.  

Treatments and Practices of the Pediatric Allergy

  • Diagnostic tests for allergic patients utilizing approximately 300 different specific IgE and component-specific IgE antibodies
  • Skin tests for allergies to pollens, house mites, cats, dogs, horses, fungi, cockroach, latex, bumblebees, wasps and numerous food items; and immunotherapy for eligible cases (in the form of a vaccine or sublingual doses)
  • Food loading (provocation) tests aimed at diagnosing food allergies or finding out whether or not reaction to food persists
  • Food immunotherapy with baked products for children allergic to cow milk and eggs
  • Determination of inadequate calcium and protein intake in cases of allergy to cow milk and multiple foods; regulation of daily calcium and protein intake for specific age groups in coordination with our dietitian
  • Skin and drug provocation tests utilizing penicillin, anesthetics and painkillers to diagnose drug allergies
  • Spirometry and plethysmography tests at the respiratory function laboratory for diagnosis, treatment and follow-up of asthma and other airway diseases
  • Impulse oscillometer test that enables respiratory function testing among children younger than five years of age
  • Follow-up and supportive treatment of allergic patients as necessary in collaboration with an allergist, dietitian, psychiatrist and psychologist 

Pollen counting

Since 2018, we have been regularly conducting pollen and fungus counts using the Burkard pollen counting device, which is installed on the attic floor of Koç University Hospital, in collaboration with the Experimental Palynology Laboratory of Ankara University-School of Medicine, Department of Biology.

Food allergy (IgE-mediated and non-IgE-mediated)

Our department is capable of carrying out skin and blood tests with numerous food items to diagnose IgE-mediated food allergy. Loading tests can be configured to varying intensities for different patients. These tests are essentially planned in accordance with severity of food allergy cases, and can be conducted during 4-5 hours of observation in the allergy test room at the polyclinic or by hospitalization at the pediatric ward/intensive care unit overnight.

Collaboration with other departments

Some non-IgE-mediated food allergy cases require observation in collaboration with the departments of pediatric allergy and pediatric gastroenterology. Also in collaboration with the departments of pediatric gastroenterology, dietetics and pathology, we hold regular follow-ups of eosinophilic esophagitis patients; make differential diagnosis and perform endoscopic/pathologic investigations of patients suspected for enterocolitis or enteropathy associated with protein allergy; and follow up on nutritional issues.

Service Subcategories of Pediatric Allergy

  • Polyclinic, observation unit, inpatient ward, emergency service, pediatric intensive care unit
  • Allergy test room: Skin allergy tests, drug and food loading tests
  • Services available at the allergy laboratory: Conventional skin tests, allergen extract-specific tests, single (RAST) or multiple-panel (microarray) specific IgE tests aimed at protein fractions/components of allergens 
  • Respiratory function laboratory: Differential diagnosis and follow-up of asthma by means of spirometry and plethysmography in addition to impulse oscillometry (IOS), a simpler method suitable for children as young as 3-4 years of age, and bronchodilator reversibility tests

“Outpatient services for hives are available from 13:30 to 16:30 on Mondays and 13:30 to 14:30 on Thursdays at Pediatric Allergy outpatient clinic.”

“Outpatient services for Atopic Dermatitis are available from 10:00 to 12:30 on Mondays and 13:30 to 15:00 on Thursdays at Pediatric Allergy outpatient clinic.”


The department treats patients with immunotherapy (allergy vaccine therapy) and serves them in differential diagnosis of allergic diseases, asthma, atopic dermatitis (eczema), urticaria (rash), angioedema, hereditary angioedema, allergic rhinitis (allergic flu), food allergies, drug allergies, anaphylaxis (allergic shock), bee allergies, mastocytosis, chronic coughing, recurrent wheezing, exercise-induced asthma, asthma presenting only with coughing, pollen-food allergy syndrome and snoring/nasal congestion.
Allergic diseases may develop in children right after birth. Allergic diseases emerge in chronological order depending on age of the child. Infants are commonly admitted with complaints of eczema and food allergy after the birth. Frequency of eczema and food allergy decreases as the child ages, while doctor visits for respiratory tract diseases such as asthma and allergic rhinitis increase after 3 years of age.

House dust mite is the most important indoor allergen. Mites are present in houses and indoor places. These creatures measure about 0.33 mm in diameter and they are too small to see with the naked eye. They eat dead skin cells, hair and fiber crops. Mites are found in feces and the substances that may cause allergy in people.
Mites like warm and humid environment. Mites need humidity rate of >50% to survive in any place. Many mites exist in houses close to the seaside. They reduce in number as sea level rises, distance to sea increases and humidity rate declines.

House dust mites are mostly found in wool house ware, especially in bed, pillow, quilt, carpet, fabric house ware, curtain-cloth made of fabric, plush toys and house dust. The reason why mites are more intensely found in such objects is about abundance of skin flakes they can eat.

Diagnosis is made through skin prick tests and/or specific IgE test under supervision of an allergist for those who complain of allergic diseases (asthma, allergic rhinitis and allergic eczema). Test results alone are not sufficient to make diagnosis. Test results should correlate with complaints.
The most important method to struggle with mite allergy is reducing the exposure to mite. Although it is not possible to eliminate mites completely in houses, they can be reduced through some measures.
Measuring 10 to 100 in size, pollens are found in flowers of plants and they are transferred by wind or insects; they originate from three sources (trees, meadow grass and weeds).
Pollens may cause onset or exacerbation of symptoms of rhinitis, allergic conjunctivitis, asthma, hives and atopic dermatitis in people with pollen allergy.
Sneezing, itchy nose, runny nose and/or nasal congestion are noted soon after exposure to the allergen in children with allergic rhinitis. Since children commonly wipe their nose upward, this movement is called allergic salute; a horizontal line may develop on the nose due to this movement. Redness, itching and watering of eyes are also common, as the condition is usually associated with allergic conjunctivitis. Nasal congestion (stuffy nose) and venous dilatation lead to swelling and dark discoloration under the eyes. Above mentioned symptoms may be associated with postnasal drip, headache and cough.
Medical history is the most important component in diagnosis of allergic rhinitis. It is necessary to address when and how the symptoms developed and what triggered their onset. Blood allergen concentration test (pollen specific IgE) and skin prick tests may detected the particles that the patient is allergic to. There is no age limitation for allergy tests; they can be done in all age ranges of babies and children.
For treatment of allergic rhinitis, the primary approach is taking measures for avoiding the allergens. Moreover, nasal sprays and oral syrup or tablets may alleviate or eliminate the complaints. It is recommended that medication treatment is planned by a physician, after severity of the allergic disease and patient’s overall condition are evaluated. Moreover, immunotherapy can be considered for patients with heavy allergic complaints who respond partially to medication treatment.
Asthma is a chronic disease, where respiratory tracts of lung, called bronchi, are attacked by substances secreted by many cels. Chronic inflammation causes recurrent wheezing, coughing, shortness of breath and chest pain. Bronchi contract and narrow in various degrees during those attacks.
Shortness of breath occurs after exposure to the allergen (pollen, mite, fungus, cat, dog, cockroach, food allergens, drug allergens, bee etc.). Typically, family history (mother, father and siblings) is notable for asthma or other allergic diseases (allergic rhinitis, allergic pink eye, eczema, food allergy). Shortness of breath, cough and wheezing triggered by cigarette smoke, odors or exercise are common in patients with asthma.
The main complaint is cough in these patients. Shortness of breath or wheezing does not occur. The condition is more common in children and one of the typical features is worsening of cough at night. Bronchoconstriction may not be demonstrated through pulmonary functions tests done in the daytime. Gastroesophageal reflux, postnasal drip, chronic sinusitis and vocal cord dysfunction should be investigated in differential diagnosis of cough.
Physical activity is a factor that worsens complaints in most of patients, while it is the only cause that triggers symptoms in some patients. Typically, exercise-induced asthma develops 5-10 minutes after the exercise. The condition may occur during exercise as well. Doing exercise may result in bronchospasm (narrowing of the airways) in any weather condition. However, the severest complaints most frequently occur while running in dry and cold air. Preventing/eliminating symptoms by using drugs that relieve breathing before and after the exercise will help the diagnosis. Exercise tests are useful for definitive diagnosis.
In treatment of asthma, bronchodilators and drugs that alleviate symptoms of asthma are used. In treatment of asthma, bronchodilators and drugs that alleviate symptoms of asthma are used. Sprays are preferred in most of the children. It is recommended that children use sprays with a spacer. In this way, much more drug particles reach the bronchi.
Anti-asthmatic drugs are not addictive. The condition is managed, asthma attacks regress and quality of life improves when patients take medications regularly.  
Increased frequency and severity of lower respiratory tract complaints are more likely in the fall in asthma patients. Among individuals with allergy, children are most severely affected by fall. Complaints worsen as the temperature drops in the fall after summer is over, rainy days increase, variety and number of virus and bacteria change, much more time is spent in houses and indoor places and exposure to indoor allergens increases.
The risk is higher in patients who have experienced asthma attacks in the prior season (summer), have low respiratory function test results and have multiple allergic sensitizations (for instance, having both house dust mite and cockroach allergy).
Mild pain, mild swelling and redness on the area of bee sting are expected reactions which everyone may experience. However people with bee allergy experience certain signs and symptoms such as generalized redness, rash, itching, swelling in body parts distant to the area of bee sting, inability to breathe due to swelling (edema) of trachea or tongue, cough, wheezing, vomiting, abdominal pain, hypotension and confusion. In these cases, the reaction is not confined to the area of bee sting; it also effects vital systems such as respiratory system and circulatory system and this reaction is referred to as anaphylaxis (allergic shock). Allergic reactions should be considered in case of these symptoms and patients should present to closest medical facility immediately.
The only protective treatment method that is proven to be effective in bee allergy is vaccination (venom immunotherapy) which is reported as 83-100% protective after the treatment is completed. Bee immunotherapy is started at low doses for people with documented bee allergy and the venom is administered beneath the skin on lateral surface of the upper arm under supervision of a physician. Allergic reactions may also occur during immunotherapy injections. Therefore immunotherapy should be performed under supervision of a physician and patients should be observed for at least 30 minutes following the injection.
The term anaphylaxis is used to describe sudden-onset, severe and possibly fatal allergic reactions. Most common cause of anaphylaxis is food; food-related anaphylaxis is especially common in children in comparison to adults. On the other hand, anaphylaxis related to drug and bee allergies is more common in adults in comparison to children.
Anaphylaxis is the severe allergic reaction which leads to sudden-onset hives and swelling in skin, respiratory problems including cough, hoarseness, and wheezing, digestive problems including vomiting, abdominal pain and diarrhea, and hypotension in terms of the circulatory system. If it is known that the individual accidentally consumed the allergic food, subsequent onset of hypotension and resultant confusion, fainting and syncope are sufficient to diagnose anaphylaxis. Other than food allergy, individuals with drug allergy and bee allergy are also under risk for anaphylaxis. The first step in treatment of anaphylaxis is Epinephrine/Adrenaline.  Epinephrine/adrenaline saves life in treatment of anaphylaxis.
Eczema (atopic dermatitis) is a chronic, recurrent, inflammatory skin disease which commonly starts in early childhood and causes itching. Eczema is the most common skin disease in children. While eczema is caused by sensitivity to allergens that are exposed through foods and breathing (polen, mite, cat, dog, fungus etc.) for some patients, an underlying cause cannot be found in others.
The most important duty of the skin is to protect us from external factors. However, the skin cannot function properly as a barrier when it is dry and the interconnections of skin cells are loose and this creates the proper base for eczema and other allergic diseases.
For children within first 2 years of age, eczema primarily involves face, scalp and external surface of arms and legs. On the other hand, lesions of eczema are observed in skin folds of arms and legs in children older than two.
Food allergy is a food-specific immune response that occurs following consumption of a particular food. Early type food allergies are characterized with hives, angioedema (swelling), anaphylaxis, rhinitis (runny nose, sneezing, itching and stuffy nose), cough, wheezing and shortness of breath which occur within few minutes or hours following ingestion of the food. Latent food allergies are generally characterized with persistent vomiting, diarrhea and blood in stool, which occur within few hours or days following ingestion of the food, as well as growth retardation and these conditions include “enterocolitis related to food protein”, “proctocolitis related to food protein” and “eosinophilic gastrointestinal diseases (eosinophilic gastritis, duodenitis, gastroenteritis and colitis”.
Nearly all foods may cause allergy. Some foods may, however, be consumed more commonly in specific societies due to certain factors such as dietary habits and cultural aspects. Eggs, cow’s milk, hazelnut, peanut, walnut, legume, wheat, sesame and meat are the foods that cause most cases of food allergy in our country, while soy, chickpea and fish allergies are less common. While peanut and shellfish allergy is more prevalent in American society, hazelnut, legume and sesame allergies are more common in our country in comparison to others.
Although food allergies commonly develop in childhood, they can emerge at any age starting from neonatal period. Egg, cow’s milk and wheat allergies generally manifest symptoms in early infancy and childhood while nut allergies may emerge in late childhood. Recently, allergy against hazelnut and other nuts are more commonly diagnosed around 1 year of age.
Although blood testing and skin prick tests can be performed to diagnose food allergy, the gold standard is “food challenge tests”. It is more appropriate to have useful tests determined by an experienced Allergic Diseases Physician in the light of the clinical history.
To treat the food allergy, it is necessary to eliminate the allergen and all foods/products that contain this allergen from the diet, and next, diet of the child should be modified accordingly, alternative foods should be recommended and growth and development should be supported. If allergy does not recover while the child ages, especially in cases of milk and egg allergy, immunotherapy (desensitization) therapy can be employed by baking the foods or directly using the foods. Since allergic reactions may develop during this therapy, it should be performed at the facilities experienced on this condition.
Babies with cow’s milk protein allergy should be fed with hypoallergenic formulas instead of the ordinary ones, if it is not possible to feed the baby with breast milk.

If babies with cow’s milk protein allergy cannot be breastfed, hypoallergenic formulas should be used instead of other formulas. A specific hypoallergenic formula is determined by the allergy physician according to type and severity of the disease and the patient’ age; a report is issued and formulas can be supplied from pharmacies.
Milk and egg allergies, which are the most common food allergies in childhood, mostly recover as the children grow up. The time when the allergy recovers differ from one child to the other. Recently, it has been observed that prevalence of food allergy increases while early milk and egg allergy persists at a higher rate after the age of 6.
Allergic reactions are most commonly induced by antibiotics (for example penicillin) and painkillers. Moreover, medications used for anesthesia (local anesthesia, general anesthesia), anti-cancer drugs, medications used for stomach diseases, medications used for epilepsy and contrast media (agents used for imaging tests) can also cause allergic reactions.