Clinical immunology consultation (Clinical immunology specialist consultation)
A consultant appointment to investigate problems with the immune system — such as frequent, severe or unusual infections — to find a cause and plan treatment or monitoring.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A consultant immunologist investigates immune problems such as frequent, severe or unusual infections to find a cause and plan care.
- Diagnosis often takes time and several tests; a single appointment rarely gives the whole answer.
- Not everyone with frequent infections has an immune deficiency — many people are reassured after assessment.
- Where a deficiency is found, treatments such as vaccines, preventive antibiotics or immunoglobulin replacement can greatly reduce illness.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
A clear, expert assessment of whether your immune system is the problem
An acute, severe infection needs urgent medical care now, not a routine clinic appointment.
You usually have initial blood tests taken and leave with an explanation of what is being investigated and a follow-up plan.
A clear plan of which tests are being done and what each would change.
You usually have initial blood tests taken and leave with an explanation of what is being investigated and a...
Routine blood results, such as immunoglobulin levels, come back and the picture starts to take shape.
More specialised tests, vaccine-response checks or genetic tests are completed, sometimes requiring repeat...
If an immune condition is confirmed, treatment is started and long-term monitoring arranged, often at a specialist...
What is a clinical immunology consultation?
Clinical immunology is the specialty that deals with the immune system — the body's defence against infection — and what happens when it does not work properly. A clinical immunology consultation is an appointment with a consultant immunologist to investigate problems such as frequent, severe, long-lasting or unusual infections, or certain immune and inflammatory conditions.
The immune system can be underactive (immunodeficiency), making infections more likely, or it can act inappropriately. Some immunodeficiencies are present from birth and inherited (primary immunodeficiency); others develop later or result from another illness or its treatment (secondary immunodeficiency).
The consultation involves a detailed history, examination, and usually a series of blood tests — for example measuring antibody (immunoglobulin) levels and how well your immune system responds. Some conditions need more specialised tests over time. The aim is to find whether there is a real immune problem, what type, and what can be done.
Not everyone who gets frequent infections has an immune deficiency, and many people are reassured. Where a deficiency is found, treatments such as preventive measures, vaccines or immunoglobulin replacement can make a major difference.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Recurrent infection assessment
Investigation of infections that are frequent, severe, persistent, unusual or hard to treat (sometimes summarised as 'SPUR'), to decide whether the immune system is involved.
Antibody (immunoglobulin) deficiency work-up
Blood tests measuring immunoglobulin levels and your response to vaccines, used to detect conditions such as common variable immunodeficiency.
Specialised immune testing
More detailed tests over time, such as immune cell counts, neutrophil and complement function, or genetic testing, where a specific condition is suspected.
Secondary immunodeficiency review
Assessment where another illness or its treatment (for example certain medicines) may be weakening the immune system, including review of vaccinations and prevention.
Preparing for your appointment
- Make a timeline of your infections: how often, how severe, where in the body, and how they were treated.
- Note any hospital admissions, courses of antibiotics, or infections needing intravenous treatment.
- Bring details of any family history of immune problems, recurrent infections or early deaths from infection.
- List all your medicines, including any that affect the immune system (such as steroids or immune-suppressing drugs).
- Bring records of previous blood tests, vaccinations and any prior specialist letters.
- Note other symptoms such as unusual tiredness, weight loss, diarrhoea, or swollen glands.
- Write down your questions, as the plan often unfolds over several appointments.
What happens
The consultant takes a detailed history of your infections and general health, and examines you. They are looking for patterns that suggest the immune system is involved, and for clues to other causes.
You will usually have blood tests, which may include a full blood count, immunoglobulin levels, and tests of how well you respond to vaccines. Depending on what is suspected, more specialised immune tests or genetic tests may be arranged over time.
You usually leave with an explanation of what is being looked for, which tests have been requested, and a follow-up plan. Because immune testing can take time and sometimes needs repeating, a clear diagnosis may not come at the first visit. The consultant explains the next steps and what each result would mean.
Is this appointment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- An acute, severe infection needs urgent medical care now, not a routine clinic appointment.
- Unproven 'immune boosting' or general 'immune system' high-street tests do not diagnose immune disease.
- If symptoms point clearly to another specialty (for example a single-site surgical infection), that pathway may be more appropriate first.
- A one-off test is rarely enough to diagnose or exclude an immune condition.
Delay or rearrange if…
- You are acutely unwell or septic — seek emergency care instead.
- You are on medicines that suppress the immune system, which can affect test interpretation and timing.
- Recent vaccines or infections may need time before certain immune tests are meaningful.
- You cannot yet gather the history, medicines and previous results that make the assessment worthwhile.
Alternatives to discuss
- GP review and basic blood tests, which explain many cases of recurrent infection.
- Referral to another specialty (such as respiratory or ENT) if infections are confined to one system.
- Watchful waiting with a clear plan for new infections where the picture is mild.
- Vaccination and prevention advice without extensive testing where appropriate.
- A second opinion at a specialist immunology centre for complex cases.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- A clear, expert assessment of whether your immune system is the problem
- Detection of treatable immune conditions that may have been missed
- Reassurance where infections are common but the immune system is normal
- A tailored plan for preventing infections, including vaccines
- Access to treatments such as immunoglobulin replacement where needed
- Coordinated long-term follow-up at a specialist centre for complex conditions
Risks & complications
- Uncertainty after the first visit, as diagnosis often needs several tests over time
- Discomfort or bruising from blood tests
- Test results that need careful interpretation and sometimes repeating
- Incidental findings on blood tests that need further checks
- Anxiety while waiting for results of investigations
- Needing referral on to other specialists depending on what is found
- A diagnosis of a serious immune condition with lifelong treatment implications
- A finding with implications for blood relatives, who may also need assessment
The main challenge is that immune problems are varied and diagnosis can be a journey rather than a single answer. Be wary of any service promising an instant diagnosis from one test. Make sure you understand which tests are being done, what each result would change, and how you will be followed up. Tell the consultant about any medicines that affect the immune system and any family history.
Published figures to discuss
Immune conditions are diverse and individually uncommon, so single 'success' or 'accuracy' figures are not meaningful. Tests are interpreted together and sometimes repeated, because results can be affected by infection, medicines and timing. The figures below are broad and for context only.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Frequent infections turning out to have a primary immune cause | A minority of those assessed | Many people are reassured; immunodeficiency is found in a smaller proportion, which is why careful selection matters. | Primary immunodeficiency overview — PMCncbi.nlm.nih.govSource-linked context |
| Need for repeat or further immune testing | Common | Diagnosis often requires more than one test over time, especially for antibody and vaccine-response assessment. | Guide sourcesClinical context |
| Secondary immune deficiency from medicines or other disease | Commoner than many primary immune deficiencies | Steroids, rituximab, chemotherapy, kidney protein loss, gut protein loss and blood cancers should be considered. | Guide sourcesClinical context |
| Immunoglobulin replacement being needed | A minority of assessed patients | UK guidance bases IgRT on infection burden, immunoglobulin levels, vaccine responses and failure of other measures, not a single low number. | Primary immunodeficiency overview — PMCncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from the appointment. 'Afterwards' is about completing the tests, waiting for results, and following the agreed plan, which may evolve over time.
- Not having a complete answer at the first appointment
- Several rounds of blood tests, sometimes weeks apart
- Waiting for vaccine-response or genetic results
- A plan that develops as results come back
Aftercare
- Complete all requested blood tests and any vaccine-response checks as arranged.
- Keep a record of infections and treatments to bring to follow-up.
- Follow any preventive plan, such as vaccines or preventive antibiotics.
- Seek medical help promptly for new infections, as advised for your situation.
- Tell other clinicians about your immune assessment, especially before vaccines or immune-suppressing treatment.
- Encourage relatives to be assessed if an inherited condition is confirmed.
- Attend follow-up so results can be reviewed and the plan updated.
- Timeline of infections prepared and updated
- Requested blood tests and vaccine checks completed
- Family history details provided
- Preventive plan (vaccines, antibiotics) understood
- Plan for seeking help with new infections clear
- Relatives' assessment arranged if relevant
- Follow-up appointment booked
⚠ Get urgent help if…
- A high fever with feeling very unwell, especially if you have a known immune problem
- A severe or rapidly spreading infection
- Breathlessness, chest pain or coughing up blood
- Signs of sepsis: confusion, very fast breathing, mottled or pale skin — call 999
- Persistent fevers, drenching night sweats or unexplained weight loss
- Any infection that is not responding to treatment as expected
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good outcome is a clear answer about whether your immune system is contributing to your problems, and, where it is, a plan that reduces infections and protects your health. For many people, the result is reassurance that their immune system is working normally, with advice on prevention.
The consultation cannot always give an immediate diagnosis, and some immune conditions are identified only after tests over time or are never fully explained. A normal set of tests is reassuring but is interpreted alongside your history, and occasionally testing is repeated to be sure.
Some immune conditions are lifelong and need ongoing treatment and monitoring, while others are temporary or related to a treatable cause. Even after a normal assessment, you should seek review if your pattern of infections changes. Treatment plans, such as immunoglobulin replacement, are reviewed regularly to make sure they remain right for you.
Related tests, treatments or support
A clinical immunology consultation is often combined with input from other specialists, such as respiratory medicine for recurrent chest infections, haematology, or infectious diseases, depending on the findings. It may also be combined with allergy assessment, as some people have overlapping allergic and immune problems.
Follow-up & long-term care
Follow-up is usually arranged to review test results and decide on treatment, and may continue long-term for confirmed conditions. Results come back over days to weeks, and some tests need repeating. Ask who to contact if you develop a significant infection while your assessment is ongoing.
- Attend regular review for confirmed immune conditions
- Keep vaccinations up to date as advised by your immunologist
- Continue any preventive treatment, such as immunoglobulin replacement, as planned
- Monitor and report changes in your pattern of infections
- Keep relatives informed and assessed where an inherited condition is found
Repeat, follow-on and what comes next
- Diagnoses are often refined as results return and tests are repeated.
- Treatment plans, such as immunoglobulin replacement, are reviewed and adjusted over time.
- Some conditions are reclassified or only identified with longer follow-up or genetic testing.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear plan of which tests are being done and what each would change.
- A named contact and route for results and for new infections.
- Coordinated long-term follow-up at a specialist centre for confirmed conditions.
- Up-to-date vaccination and prevention advice.
- Assessment of relatives where an inherited condition is confirmed.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Length and complexity of the consultation
- The range of blood and immune tests requested
- Specialised tests such as vaccine-response, immune cell or genetic testing
- Repeat testing where results need confirming
- Follow-up appointments and long-term monitoring
- Treatments such as immunoglobulin replacement, which are specialist and ongoing
- The consultant's appointment fee
- Which tests are included and the cost of specialised or genetic tests
- Cost of repeat testing if results are unclear
- Cost of follow-up appointments and ongoing monitoring
- Whether onward referral or specialist treatment is included
- What happens, and what it costs, if the assessment is inconclusive
- Cancellation policy
On the NHS? Clinical immunology is provided on the NHS when clinically indicated, with specialist centres for complex conditions; private appointments may be used for speed or a second opinion.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being promised an instant diagnosis from a single test.
- Being sold 'immune boosting' tests or treatments with no evidence base.
- Not understanding which tests are being done and why.
- No clear follow-up plan for results that take time.
- Not being told about implications for relatives where a condition is inherited.
Marketing red flags
- 'Complete immune system check' marketed as catching everything.
- Supplements or infusions sold to 'boost immunity'.
- Claims to diagnose immune deficiency from one quick blood test.
- Promising to cure recurrent infections without proper assessment.
- Downplaying the need for specialist follow-up of serious conditions.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Based on my history, do you think my immune system is the problem?
- Which tests are you requesting, and what would each result change?
- How long should I expect this to take, and will tests need repeating?
- Could any of my medicines or conditions be weakening my immune system?
- If you find a deficiency, what treatments and monitoring would I need?
- Should any of my relatives be assessed?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my appointment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this appointment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Does getting a lot of infections mean my immune system is faulty?
How long does it take to get a diagnosis?
Can I be seen on the NHS?
What is immunoglobulin replacement?
Could an immune problem run in my family?
What can I do to prepare?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: UK Primary Immunodeficiency Network (UKPIN) Immunodeficiency UK — symptoms and diagnosis NHS — Sepsis (when to get urgent help with infection) British Society for Immunology — about clinical immunology Primary immunodeficiency overview — PMC
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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