and Immune System Disorders

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Duke allergy specialists offer the latest in comprehensive, personalized care for all types of allergies. We also treat people with immune system disorders including common variable immune deficiency (CVID), hypogammaglobulinemia, and antibody deficiency syndromes. Our goal is to educate and empower you to control your allergies and offer comprehensive care for your immune system disorders.

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About Allergies and Immune Disorders

If you suffer from any type of allergy -- whether it’s seasonal allergies, venom and insect allergies, or food and drug allergies -- or chronic hives or immune problems, our specialists can help.

We offer a comprehensive program for treating allergies and immune disorders. Our specialists use the latest knowledge, gained from research studies and clinical trials, to assess your condition and create treatment options that fit your specific needs. Clinical trials help us develop treatment options that are faster, more effective, and less painful than traditional options available elsewhere. In addition, we prepare all of our allergy vaccines on-site to fit your individual allergy treatment needs.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.



We prepare allergy vaccines -- also known as allergen immunotherapy -- on-site. We tailor them to meet your individual treatment needs and to ensure the best possible results. The production process meets the highest industry standards for sterility. Allergen immunotherapy includes:

  • Standard immunotherapy, which desensitize you to pollen, insect stings, or other allergens over a period of several months
  • Cluster and rush immunotherapy, which speed up desensitization to occur over a period of days or weeks

Omalizumab (Xolair)

Targets a molecule called IgE, a protein found in high levels in the blood of people with allergic asthma. Administered by trained nurses in clinic, it is recommended for people with poorly controlled allergic asthma who don't respond to conventional therapy.

Healthy Habits

Prevention options and treatments for lung rehabilitation and wellness include smoking cessation and nutrition guidance.

Asthma Nebulizers

A breathing machine may be recommended if you have trouble using inhalers. This machine changes liquid asthma medications into a mist that is inhaled through a mask or mouthpiece.

Immunoglobulin Replacement Therapy

Antibody or immunoglobulin replacement is frequently a treatment option for people with immune deficiency. If your immune system does not produce enough immunoglobulin, you may need lifelong infusion. The immunoglobulin is administered through intravenous (IV) line or through needles inserted into the skin (subcutaneous) that are connected to a portable pump. Therapy can be given in the hospital or at home.

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Skin Testing

Painless skin testing, performed without the use of needles, can help determine what inhalants, pollens, molds, foods, or insect venoms trigger your allergic reactions.

In-Vitro Immunoglobulin E (IgE) Testing

Determines the cause of an allergic reaction from foods or other substances. 

Methacholine Challenge Testing

Confirms allergic asthma diagnosis by testing how your lungs function after inhaling methacholine. If you have allergic asthma, your lung function will decrease as your airways constrict.


Tests how your lungs function, including the volume and speed with which you inhale and exhale air.

Best Hospital for Pulmonology and Lung Surgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our pulmonology and lung surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Expert Care for Allergy Relief and Immune Deficiencies

We provide allergy injections and offer on-site diagnostic testing, respiratory testing, and laboratory testing five days a week. Same-day appointments are possible for current patients who need immediate attention.

A Team of Experts
Our dedicated staff has years of experience detecting all types of allergies and immune system disorders. We also have health providers who work exclusively on testing for food and drug allergies -- including penicillin allergies -- to pinpoint your diagnosis and recommend the most effective treatment plan.

Personalized Approach to Allergy Care
The underlying cause of allergy symptoms can be different in each individual. We use advanced techniques to identify what type of inflammation you have in your lungs and tailor your treatment to your needs. We also give you access to omalizumab (Xolair), a targeted therapy for severe allergic asthma that is only available at specialized centers like ours.

Since allergies may involve other potentially serious health problems such as nasal polyps, sleep disturbances, asthma, and repeated sinus infections, our specialists work with many experts throughout Duke to provide you the best care. Likewise, we work with specialists across Duke to help you manage immune deficiencies including common variable immune deficiency (CVID), hypogammaglobulinemia. and antibody deficiency syndromes

Painless Treatment Options
Our specially trained nurses provide quick, painless skin testing without the use of needles for pollen allergies.

Access to our Clinical Trials
You may be eligible to participate in our ongoing clinical trials, which explore new therapies that may help develop faster, more effective allergy treatment options. 

Local Allergy Testing
We measure local allergens and molds daily to test for allergies triggered in our area.

Ongoing Research
We conduct studies on immune disorders, with the goal of developing better, more effective treatment options in the future.