The Allergist – Détails, épisodes et analyse

“People know that asthma sucks. They don’t know that sinus disease sucks. It really impacts people's quality of life. It impacts their function. It needs to be taken very seriously.” — Dr. Andrew Thamboo

Chronic sinusitis doesn’t just clog the nose—it can drag down quality of life, complicate asthma, and leave patients caught between specialists. Dr. Mariam Hanna talks with Dr. Andrew Thamboo, rhinologist at St. Paul’s Sinus Centre in Vancouver and clinical associate professor at UBC, about how to identify, manage, and treat this stubborn condition. A leader in chronic sinus disease research, Dr. Thamboo explains how understanding inflammation, using the right investigations, and choosing the right therapies can make a real difference for patients who feel like nothing works.

In this episode:

• How to distinguish chronic rhinosinusitis from acute sinusitis, and why type 2 inflammation matters
  
  
• The role of CT scans in diagnosis and when to order one before referral
  
  
• What nasal endoscopy patterns reveal about atopy and when allergy testing changes the treatment plan
  
  
• Why saline irrigations combined with topical steroids remain the baseline therapy, and why oral corticosteroids are falling out of favour
  
  
• When medical management has gone far enough and surgery becomes the next step
  
  
• The evolving place of biologics, cost considerations, and how biosimilars could shift the future of care
  
  
  
• Why managing sinus disease seriously improves both airway and overall health

Sinus disease may suck, but as Dr. Thamboo explains, understanding inflammation, anatomy, and timing can make all the difference for patients and physicians alike.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“The immune system generally likes to be a well-balanced machine. It’s kind of like Goldilocks — too much is no good, too little is no good, and it’s finding that balance.”  Dr. Vy Kim

Tregs have been called therapists, peacekeepers, and now—thanks to this year’s Nobel Prize—front-page immunology. Dr. Vy Kim joins Dr. Mariam Hanna to unpack why these cells might hold the key to everything from tolerance to therapy response, and what allergists should be watching for next.

• How Tregs bridge central and peripheral tolerance—and why that matters in allergy.
• What their dysfunction reveals about the origins of allergic disease.
• Why allergen-specific Tregs could signal immunotherapy success.
• How far we are from clinical testing and therapeutic manipulation.
• What “Goldilocks” balance really looks like inside the immune system.
• The unanswered questions that will shape the future of Treg-based interventions.

It’s not every day the Nobel Prize lines up with what’s happening in your clinic. This is one of those days.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“Have a high clinical suspicion for contact allergens or irritants in anyone presenting with eczematous rash.” —Dr. Rebecca Pratt

Creams that sting and rashes that won’t quit —welcome to the complex world of contact dermatitis. Dr. Rebecca Pratt joins Dr. Mariam Hanna to unpack why diagnosing and managing this condition is anything but straightforward.

Dr. Pratt is an allergist and clinical immunologist in St. Catharines, Ontario, with a passion for dermatoimmunopathology and practical tools that empower patients. She breaks down when to patch test, what to suspect, and how to help patients take control.

On this episode:

• Why 80% of contact dermatitis cases are irritant—not allergic
  
  
• Clues that point to allergic contact dermatitis, especially in recurring facial, hand, or foot rashes
  
  
• How to approach patch testing in adults and kids, including when immunosuppressants or UV exposure may interfere
  
  
• What to do when results are negative—and why that still matters
  
  
• The reality of managing allergens found in foods, not just topicals
  
  
• Why there’s no one-size-fits-all answer to the sunscreen question—and how physical blockers stack up

There may be no cure for contact allergy, but there’s power in knowing what to avoid.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“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.

Dr. Biggs breaks down the clinical signs that should raise your suspicion and explains why early recognition and genetic testing can make all the difference. From STAT6 gain of function to when (and when not) to reach for dupilumab, this episode offers a roadmap for spotting zebras.

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.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“It doesn’t have to start with a huge trial. It starts with a patient and it starts with a problem.” —Dr. Gord Sussman

How do we move from the exam room to the frontlines of discovery? On this episode of The Allergist, Dr. Mariam Hanna talks with Dr. Gord Sussman about how curiosity—not a research grant—launched his decades-long contribution to allergy science. From identifying the early signs of latex allergy to shaping the treatment landscape for urticaria and hereditary angioedema, Dr. Sussman shares what keeps him asking the next question, and how any allergist can get involved.

On this episode:

• Why Dr. Sussman initially thought he’d never pursue research—and what changed his mind
  
  
• How one nurse's anaphylactic reaction to latex launched a field of study
  
  
• What it was like to design and run early research trials for food allergy challenges and peanut desensitization
  
  
• Why recruiting patients for trials has become harder—not easier—over time
  
  
• What makes a good research coordinator and why infrastructure is critical
  
  
• How to identify patients who may be open to research, and when not to push
  
  
• Why some promising drugs never reach market—and what frustrates Dr. Sussman most
  
  
• What advice he gives to allergists who are research-curious but hesitant
  
  

You don’t need a lab coat to help change practice. Just curiosity, commitment—and maybe a really good clinical coordinator.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“We have to keep in mind that urticaria has to be treated until it's completely gone. So, absolute control of the disease.” 

— Dr. Herminio Lima

Chronic spontaneous urticaria has long been managed with the goal of complete symptom control. But for many patients, that goal remains elusive. In this episode of The Allergist, Dr. Mariam Hanna talks with dermatologist and clinical immunologist Dr. Herminio Lima about the updated urticaria guidelines—and how new treatment options are giving clinicians more ways to act, and more hope for getting patients all the way to control.

On this episode:

• What’s new in the 2025 guideline—including additional second-line options beyond antihistamines
  
  
• Why nearly 40% of patients may need to escalate to biologics
  
  
• How remibrutinib compares to omalizumab and what its trials revealed
  
  
• What the CUPID studies say about dupilumab, especially in biologic-naive patients
  
  
• Key safety signals and clinical considerations for the new treatment options
  
  
• How to move toward full disease control—and why suboptimal outcomes are no longer acceptable

Complete control is still the destination, but the path to get there is about to get a lot more flexible.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

 "The emergence of biologics has really significantly transformed the management of these patients for me."
 — Dr. Yvonne Chan

When it comes to nasal polyps, the landscape is shifting fast. On this episode of The Allergist, Dr. Mariam Hanna is joined by otolaryngologist Dr. Yvonne Chan to talk about how biologics, surgery, and multidisciplinary care are working together to reshape care for this stubborn condition. From recognizing key symptoms to navigating the latest therapeutic options, Dr. Chan shares practical insights to help physicians better support patients with nasal polyps.

On this episode:

• How to differentiate nasal polyps from other causes of chronic nasal obstruction
  
  
• When imaging should be ordered and what findings are suggestive of polyps
  
  
• The role of allergy testing and comorbid conditions like asthma and AERD
  
  
• How biologics have changed the game—and which patients are ideal candidates
  
  
• When surgery is still needed, even in the era of advanced medical therapies
  
  
• The importance of long-term follow-up and multidisciplinary collaboration

Listen now, because when it comes to managing nasal polyps, the right team and the right tools can make all the difference.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

"We are all learning and we are all teaching." – Dr. Lori Connors

What makes a great medical educator—and how do you actually become one? On this episode, Dr. Mariam Hanna is joined by Dr. Lori Connors, an allergist, seasoned teacher, and newly appointed Associate Dean of Continuing Professional Development and Medical Education at Dalhousie University. 

They explore the journey to becoming a great medical educator, how competency by design is reshaping training, and how to support the next generation of learners.

Here’s what you’ll learn:

• How Dr. Connors’ path to teaching began with a strong mentor (and a family full of educators)
  
  
• The evolution of medical education: from informal teaching to formal training, portfolios, and competence committees
  
  
• Why observation and feedback—good feedback—are key to coaching for change
  
  
• How residency programs are adapting to incorporate wellness, fatigue risk management, and cultural competence
  
  
• The case for moving beyond shame-based “pimping” toward safer, more effective ways of questioning and challenging learners
  
  
• Strategies to meet different learning styles and generations—plus why podcasts and other media are a growing part of the mix
  
  
• Challenges facing medical educators today, from limited clinic space to a changing educational landscape

Whether you're shaping the next generation or figuring out your own place in it, this episode offers practical insights and a reminder that great educators never stop learning themselves.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“We need time to fix our time problem. And we can get stuck in this loop where we’re like, ‘I have no time to find time to make time to fix time.’”                                                          – Dr. Scott Cameron

Is your schedule running you—or are you running your schedule?

On this episode of The Allergist, Dr. Mariam Hanna is joined by pediatric allergist and clinical immunologist Dr. Scott Cameron to talk about the chaos of clinical practice and how to take back control. With tips that go far beyond time management, Dr. Cameron shares practical strategies for streamlining clinic operations, handling unpredictable days, and investing in smarter workflows—without burning out.

On this episode:

• The hidden culprits of clinic inefficiency—and how intake forms can help fix them
• How to triage patients better, with tips for predicting complex visits
• How to schedule around unpredictability—like anaphylaxis challenges—so they don’t derail your entire day
• The “project day” concept: why setting aside time for workflow projects can save you hours down the line
• Cutting down on admin overload with physician-driven templates, better patient communication, and targeted uses of AI
• How pairing with trainees can preserve teaching time and clinic flow
• Making time-saving tools work for you: from smart goals and macros to QR codes and intake automations

Get practical. Get faster. Get home on time. It’s all about working smarter—not harder.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

"The key to the diagnosis of these disorders is the suspicion of these disorders."

— Dr. Luis Murguia Favela

Immune dysregulation isn’t just about infections—autoimmunity, inflammation, and even malignancy can be clues that something deeper is at play. With over 500 known inborn errors of immunity, allergists are increasingly on the front lines of identifying these conditions. But when should we suspect immune dysregulation, and what does cutting-edge treatment look like today?

Dr. Mariam Hanna is joined by Dr. Luis Murguia Favela, pediatric immunologist and founding chair of the Clinical Immunology Network for Canada, to break down the growing world of immune dysregulation and how allergists can spot it.

On this episode:

• What is immune dysregulation? How inborn errors of immunity have expanded far beyond primary immune deficiencies.
• The 11th warning sign: Why early-onset, unusual, or difficult-to-treat autoimmunity, inflammation, or malignancy should raise red flags.
• Not just for kids: Many inborn errors of immunity present in childhood, but 30% of cases emerge in adults—and often go unrecognized.
• Suspicion before sequencing: Why a strong clinical suspicion is more important than access to genetic testing.
• Targeted treatments and the future of immunology: From biologics to gene therapy, where immune dysregulation treatment is headed.

With a growing number of identified inborn errors of immunity, the role of allergists in spotting immune dysregulation has never been more critical. Be suspicious, always.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions