The Allergist Episode 44 – Trust Your Gut and Test for Primary Atopic Disorders

The A
See the forty-fourth episode's transcript
Listen on Apple Podcasts
Listen on Spotify
Listen on other platforms

“If you’re already wondering if a patient has an underlying inborn error of immunity, then it’s worthwhile to do that testing.”

– Dr. Catherine Biggs

What if that tough case in your allergy clinic isn’t just unusually severe, but fundamentally different? On this episode of The Allergist, Dr. Mariam Hanna speaks with pediatric immunologist Dr. Catherine Biggs about primary atopic disorders, rare inborn errors of immunity that masquerade as everyday allergy but demand a very different approach.

On this episode:

  • What makes primary atopic disorders different from severe, polygenic allergic disease 
  • Red flags: when eczema, asthma, or food allergy suggest an underlying immune disorder 
  • Which patients warrant genetic testing—and how to approach it in practice 
  • The most important lab work to order (and why it might still come back normal) 
  • STAT6 gain of function and other key genetic culprits allergists should know 
  • When biologics are appropriate, and when they might delay definitive treatment 
  • The power of collaborative care: how one hospital built a severe atopy working group

Don’t let these patients fall through the cracks, because sometimes, it’s not “just” allergy.

Posted on June 10, 2025.