The paediatric immunology service covers the West Midlands and is based at Heartlands Hospital. Our service provides specialist diagnostic and treatment services for those with suspected and confirmed disorders of the immune system. Services are provided for children and young people, up to the age of 18 years.
What does the immune system do?
The immune system fights infections such as viruses and bacteria. It helps the body recover from illness and injury and remembers germs it has seen before so it can respond more quickly in the future.
The immune system also plays an important role in preventing disease by identifying and removing damaged or abnormal cells.
Immune problems
Immune problems happen when the immune system does not work the way it should. A weak immune system leads to the body having trouble fighting infections. This is known as immunodeficiency.
Immunodeficiency can be primary (from birth), or secondary (develop later). People with immunodeficiency may get sick more often, and infections may last longer and be more severe.
Primary immunodeficiency disorder
A Primary Immune Deficiency (PID) is a condition where parts of the immune system is missing or not working. This results in reduced or no natural defence against germs such as bacteria, fungi and viruses, which surround us every day. The consequences are that people with PID get infections more often and can take longer to get better.
Examples of Primary Immune Disorders include:
- Severe Combined Immunodeficiency (SCID) - often called “bubble boy disease,” children with SCID have very weak immune systems and struggle to fight even mild infections
- Common Variable Immunodeficiency (CVID) - children may have low levels of antibodies, leading to frequent sinus, ear, and chest infections
- X-Linked Agammaglobulinemia (XLA) - a condition where the body cannot make certain types of antibodies, causing repeated infections
- Chronic Granulomatous Disease (CGD) - immune cells can’t kill certain bacteria and fungi, leading to deep or serious infections
- Hyper-IgE Syndrome (Job's Syndrome) - children can have very high IgE levels, eczema, skin infections, and lung infections
- DiGeorge Syndrome (22q11.2 deletion) - a condition that can affect the thymus, heart, and immune system
- Autoimmune lymphoproliferative syndrome (ALPS) - a rare genetic disorder associated with an excessive number of lymphocytes, leading to enlargement of the lymph nodes and the spleen. These lymphocytes can attack other parts of the body, particularly other blood cells, leading to autoimmune disease. This often shows up as anaemia or bruising
Secondary immunodeficiency disorder
Secondary immunodeficiency (SID) occurs when the immune system is weakened by another treatment or illness. It is an acquired immunodeficiency because of, disease or environmental factors, such as HIV, malnutrition, or medical treatment (e.g. chemotherapy).
Treatment
The treatment you receive will be dependent on the type of immune deficiency you have and how it affects your immune system.
Treatments can include:
- Immunoglobulin replacement therapy - this replaces the antibodies that the body cannot make to help fight infection. It is normally administered subcutaneously (SCIg). This involves an injection, into the fatty tissue under the skin (most commonly into the stomach or thighs). This is safe to do at home after training and education. Another alternative you may be offered is intravenously (IVIG) this is given through a cannula/port and is administered in hospital
- Prophylactic antibiotics and/or antifungal medicines which are given daily to stave off infection
- Immune suppressant drugs such as cyclosporin/sirolimus
- Monoclonal antibodies (mAbs) Infliximab, Tocilizumab, Rituximab, Vedolizumab
- Enzyme replacement therapy: such as Elapegademase (Revcovi) used to treat ADA – SCID
- More specialised treatments and potential cures include bone marrow transplantation and gene therapy where we liaise with Great Ormond Street (London) and Great North Children’s Hospital (Newcastle)
Hereditary Angioedema (HAE)
Hereditary Angioedema (HAE) is a rare genetic condition that causes sudden episodes of swelling in different parts of the body. The swelling can affect the face, hands, feet, stomach, or airways. It is not caused by allergies.
People with HAE are born with a problem in a protein that helps control swelling in the body - most commonly the C1 inhibitor. When this protein doesn’t work properly, fluid can leak into tissues and cause painful or uncomfortable swelling episodes, lasting hours to days. Airway swelling is rare but serious and needs urgent treatment. Stomach attacks can cause severe stomach pain, vomiting, or diarrhoea.
Treatment
Medicines are used as soon as swelling starts to stop the attack from getting worse, or your child maybe given a from of prophylaxis to prevent recurrent attacks. They work by replacing or blocking the proteins that cause the swelling.
Rescue medication includes:
- C1 inhibitor replacement therapy – Berinert / Cinryze - Intravenous injection
- Icatibant – Subcutaneous injection
- Prophylactic medication such as:
- Lanadelumab
- Berotralstat
Although there is no cure, HAE can be well managed with the right medications and care plan.
Transition
We work closely with the adult immunology service and can transition our paediatric immunology patients to the adult immunology service, smoothly and gradually. This process usually begins in their teenage years.
Meet the team
- Scott Hackett, Consultant Paediatric Immunologist
- Helen Creed, Immunology Nurse Specialist
- Elisa Iles, Immunology Nurse Specialist
- Clare Webb, Immunology Nurse Specialist
Contact us
Immunology Nurse Specialist
Available Monday to Friday, 08:30 - 16:30.
Immunology Medical Secretary
Last reviewed: 06 March 2026