Skip to Main Content Go to Sitemap

Immunology & Allergy

profile view of doctor and young patient looking at each other

The Division of Immunology and Allergy provides comprehensive consultative care for patients with inborn errors of immunity and complex allergic diseases. The Division offers six Immunology and Allergy sub-specialty clinics, an immunoglobulin replacement program and inpatient consultative services. We see approximately 1,400 patients annually in our Immunology and Allergy clinics. 

The Immunology clinic provides diagnosis and treatment of patients with genetically inherited disorders of the immune system. Patients are referred from across Canada for diagnosis and recommendations for management. The Division works collaboratively with the Bone Marrow Transplant team to provide advanced immunodeficiency management, such as hematopoietic stem cell transplant, to those patients with inborn errors of immunity who may benefit from such therapies. 

The Allergy clinic is a referral clinic for the diagnosis and management of children with complex allergic diseases including multiple drug allergies, vaccine allergy, food allergies and patients with complex medical conditions followed by SickKids who require an allergy assessment. The clinic and consultative service provide allergy testing, challenges and desensitizations as needed. Patients with common allergies are referred to designated allergists in the community. 

Our Division offers a comprehensive subspecialty residency program that is accredited by the Royal College of Physicians and Surgeons of Canada and a world-renowned fellowship program, enabling trainees to gain in depth experience in a broad range of clinical and theoretical immunology and allergy, including translational and basic research. 

What we do

A regional, national and international referral centre

The Primary Immunodeficiency (PID) program at SickKids is the largest centre in Canada. It provides consultation services to over 2,000 outpatients referred from physicians and hospitals across Canada and in-patients with highly complex disorders such as Severe Combined Immune Deficiency Syndrome, receiving highly specialized bone marrow transplant procedures.  

This centre will ensure that SickKids' renowned bedside to bench to bedside process continues, allowing the hospital to produce new generations of research and clinical leaders who know why, for example, a common infection causes only a cold in some individuals, while in others it causes devastating meningitis.

World Allergy Organization (WAO) Center of Excellence designation badge

WAO Center of Excellence

The SickKids Food Allergy and Anaphylaxis Program (FAAP) has been designated as a WAO Center of Excellence (WCOE) by the World Allergy Organization (WAO) (2023–2025 term). The WCOE recognizes organizations and societies that align with the WAO’s mission and vision and have demonstrated excellence in scientific and clinical research, education and training. 

Read the announcement

Programs and services

Adelle Atkinson, MD
Eyal Grunebaum, MD
Chaim Roifman, MD 
Vy Kim, MD
Julia Upton, MD

At the most extreme end of inherited primary immunodeficiencies are children with Severe Combined Immunodeficiency (SCID). These children have a complete absence of both T and B lymphocyte function, which is essential to lead a normal life. The absence of these types of functional white blood cells puts the very young child at risk for serious life-threatening infections, specifically opportunistic pathogens such as fungus, viruses and pneumocystis jiroveci pneumonia (PJP).

Clinically, these young infants have recurrent severe infections, failure to thrive, diarrhea and sometimes skin rashes. Treatment options for SCID are currently limited to bone marrow transplantation, which involves infusing stem cells from a healthy donor who matches the patient. These transplants are either full-matched sibling transplants or matched unrelated donor transplants.

The BMT Program for primary immunodeficiencies at SickKids is the only one of its kind in Canada. It is a leader in the field of Transplantation for SCID both in Canada and around the world. In the late 1970s the first national transplant for primary immunodeficiencies was performed here, and since that time approximately 50 or more similar transplants have been performed. This is an extremely significant number given the rarity of these conditions.  

The first national matched unrelated donor transplant was also executed at SickKids in 1990 in a patient with Omenn’s Syndrome, and since then SickKids holds the highest survival rate for these transplants at 77 per cent compared to 61 per cent in European centres. This transplant program provides care to children all across Canada with a wide variety of immunodeficiencies such as IL-2R deficiency and ADA deficiency, and many types of autosomal recessive and X-linked diseases.

Both before during and after the actual Bone marrow transplant, the SickKids Immunology Team is very involved with each patient and their family in terms of locating a potential donor and devising a plan of care. After the transplant, the Immunology Team follows the patient very closely to provide complex post-transplant care. With a true "bench to bedside" approach to patient care, this program provides genetic diagnoses and outstanding therapeutic practices/clinical care for these patients, while adding to the growing body of knowledge about patients with these inherited disorders.

Chaim Roifman, MD
Eyal Grunebaum, MD
Julia Upton, MD
Vy Kim, MD
Jessica Willett-Pachul, RN, MN

There are a number of inherited disorders of the immune system that are characterized by patients lacking the ability to produce antibodies. Patients with documented antibody deficiency syndromes are enrolled into the gammaglobulin treatment program at SickKids. Once stable on therapy, patients may receive their treatment in a community hospital that is closer to home and be monitored by a community care physician.

The program team consists of a clinical nurse specialist and clinical immunologists/allergists. They monitor the patients’ laboratory results from the community and assess the patients at routine clinic appointments at SickKids. The Immunology Team is always available for consultation to the patients and physicians in the community. This treatment model allows for patients to have the expertise of the SickKids team, while at the same time allowing for care to be delivered in a convenient location for patients and families.

Patients in the program are also monitored for infections by history, pulmonary function tests, and CT scans of their lungs to determine if lung disease develops. As well, liver function tests and viral screening are performed to monitor the safety of gammaglobulin therapy, by screening for possible viral transmission through the blood product. With a long-term follow-up on over 150 patients, the Hypogammaglobulinemia Program at SickKids is one of the largest treatment programs for this patient group in the world. In being viewed as world leaders in the management and treatment of hypogammaglobulinemia, Dr. Roifman and the Clinical Team involved in this program have been invited to participate in National and International Consensus Conferences on patient management of hypogammaglobulinemia and gammaglobulin therapy.

Eyal Grunebaum, MD
Adelle Atkinson, MD
Vy Kim, MD
Julia Upton, MD
Carmen Riggioni, MD
Peter Vadas, MD

Launched in 2013 by Dr. Eyal Grunebaum, the SickKids Food Allergy and Anaphylaxis Program (FAAP) is leading the development of breakthrough research to progress the field of food allergy.

This includes conducting immunological research to understand the mechanisms of food allergy and anaphylaxis for prevention and treatment, performing clinical trials to evaluate treatment options for milk, peanut, and tree nut allergies, and providing educational activities for patients and health care providers. An additional goal of the FAAP team is promoting public awareness of food allergies. The main vision of the SickKids FAAP team continues to be a future without the fear of food.

Chaim Roifman MD
Harjit Dadi PhD 

Diagnostic information for patients with primary immunodeficiencies (PIDs) in Ontario and across Canada will be provided via techniques such as protein identification, cloning and sequencing, and a state-of-the-art flow cytometry facility. This strictly pertains to service rendered for already known entities. As new types of PIDs are discovered, the service will adapt quickly and implement accurate and reliable tests. This facility currently includes a modernized immunology service laboratory, located near relevant research activities to their mutual benefit.

Immunology & Allergy Clinics

Read the Immunology & Allergy Clinics referral guidelines (PDF).

  1. Allergy Clinic See contact details, prepare for your next visit and see what you need to bring.
  2. Immunology Clinic Our general referral clinic. See important details here.
  3. Advanced Immunodeficiency Management (AIM) Clinic See contact details, location and more.
  4. Immunology Deficiency Early and Advanced Diagnostic Clinic (IDEA) See details about this clinic for patients with complex conditions associated with known or suspected Immunodeficiency.

Who we are

The Division's team members are involved in various clinical and research activities related to paediatric immunology and allergy.

  • Maria Asper 
  • David Hummel
  • Audrey Segal
  • Lucy Duan

  • Jessica Willett Pachul (Clinical Nurse Specialist) 
  • Myra Pereira (Clinical Nurse Specialist)
  • Anna Kasprzak (Registered Nurse)
  • Maricelle Tia (Registered Nurse)
  • Wendy Shama (Social Worker) 

  • Abdulrahman Al Ghamdi
  • Azhar Al Shaqaq
  • Ashna Asim
  • Kristin Hunt
  • Yousef Alabdeen
  • Netusha Thevaranjan

Research activities

The SickKids Food Allergy and Anaphylaxis Program actively conducts both clinical trials and basic research to better understand factors influencing the development of tolerance to food allergens, improve approaches to diagnosing allergies, and evaluate novel, safer and more effective treatment options.

Clinical trials 

Within the Division of Immunology and Allergy there are currently 6 clinical trials in-progress, including:

  • Two on-going clinical trials investigating potential low-dose oral immunotherapy (OIT) treatments for children allergic to nuts.  
  • A phase III clinical trial evaluating the short- and long-term efficacy of epicutaneous immunotherapy in young children. Patients are given patches containing peanut allergen to determine if desensitization to peanut is achieved over time.  
  • A trial investigating the use of omalizumab (an asthma medication) to facilitate safer and faster OIT for multiple allergens at the same time.  
  • A clinical trial focusing on the use of platelet activating (PAF) inhibitors to manage allergic symptoms is in planning.  

More details about some currently enrolling trials can be found on Research4Kids, or please contact for more information.

Translational research projects 

  • Investigating human models for food allergy which can be used as a platform for drug testing such as human gut tissue model (Eiwegger Lab) and animal models of peanut allergy (Grunebaum Lab). 
  • Understanding the immunological mechanisms that contribute to the development of food allergies in patients with existing immunodeficiencies or after organ transplantation  
  • Developing novel methods to diagnose and predict nut allergy with a higher degree of precision than current diagnostic approached 
  • Identifying unique patterns of food allergen recognition by the immune system 
Empty lecture hall of 15 rows and a speaking podium

Education and training opportunities

Program directors

  • Dr. Vy Kim – Program Director, Paediatric Clinical Immunology & Allergy Residency 
  • Dr. Chaim Roifman – Program Director, Paediatric Clinical Immunology & Allergy Fellowship 

Paediatric Clinical Immunology & Allergy Residency Program

The goal of this program at SickKids and the University of Toronto, is to generate subspecialists in Paediatric Immunology and Allergy, who will provide the medical community with expert consultation. This two-year program attracts trainees from around the world and exceeds the essential clinical and laboratory elements that permit outstanding training in Clinical Immunology and Allergy.  

The program provides individual training, with flexibility to accommodate trainees’ interests and career goals by presenting opportunities for focusing on immunology, allergy, academia, or community practice. Clinically, the program offers extensive inpatient and outpatient learning experiences through efficiently structured rotations, rounds, and clinics that are embedded with well-organized academic content. There is extensive exposure to diagnosis and management of primary immunodeficiencies with a high level of case diversity, with strong links with the Adult Clinical Immunology and Allergy residency program at St. Michael's Hospital 

The program is committed to the incorporation of research training into the program. The faculty of the Division of Immunology and Allergy at SickKids are committed to guiding residents through all aspects of research. A mandatory research project, along with directions on proposal and grant applications, encourage the participation of residents in tangible publications. The accommodating and experienced staff, diverse patient population, availability of cutting-edge resources and an office with personal working space, all provide the trainees with an excellent learning environment. 

Advanced Food Allergy Clinical Fellowship

The Advanced Food Allergy Clinical Fellowship is a one-year full time position that is open to Canadian and international physicians who have completed an accredited subspecialty training program in Clinical Immunology and Allergy (or its equivalent). The fellowship offers clinicians comprehensive and in-depth training in the diagnosis and management of food allergies.

SickKids, located in Toronto, Ontario, Canada and affiliated with the University of Toronto, is Canada's largest and one of the world’s leading paediatric academic health- care institutions.  

As innovators in child health, SickKids improves the health of children by integrating care and research. SickKids is one of only two centres in Canada that has been designated as a World Allergy Organization (WAO) Center of Excellence, which recognizes the innovative clinical, educational, and research work that is performed by the clinicians and scientists within the Division of Allergy & Immunology.  

The Allergy Clinic is a referral clinic for the diagnosis and management of children with complex allergic diseases including multiple food allergies and patients with complex medical conditions followed by SickKids who require an allergy assessment. The clinic provides allergy consultations, testing, and challenges as needed.  

The Food Immunotherapy Clinic offers longitudinal care and immunotherapy, which is an emerging and important treatment option for patients with food allergies. 

The fellowship offers the successful candidate the opportunity to be a fully integrated team member in the Allergy and Food Immunotherapy clinics at SickKids. The fellowship will allow the trainee to enhance their knowledge and skills in the advanced care of children with food allergy, including medically complex patients, multiple food allergies, severe atopy, advanced diagnostics, and cutting-edge treatments.  

Trainees will participate longitudinally in the Allergy and Food Immunotherapy clinics and may be required to participate in overnight, weekend and holiday calls. Clinical supervision will be provided by staff within the Division of Allergy & Immunology with regular assessments, observation and feedback provided. 

Applicants from the Paediatrics or Internal Medicine stream are welcome to apply. The fellowship accepts Canadian and international applicants, although preference will be given to Canadian applicants. 

Applicants must: 

  • Be a holder of a Medical Doctor (MD) degree or equivalent 
  • Have successfully completed a subspecialty residency program in Clinical Immunology & Allergy accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC) or equivalent accredited training prior to the start of the fellowship 
  • Be eligible for, or have written the RCPSC subspecialty examination in Clinical Immunology & Allergy or equivalent 
  • Be eligible for an educational medical license in the province of Ontario. 

Previous research or academic scholarly experience is not required but will be considered an asset. 

This position is fully funded by the Food Allergy & Anaphylaxis Program at SickKids at a rate equivalent to PGY5/6 level with benefits. 

The start date will be determined by the Food Allergy & Anaphylaxis Program. 

Interested individuals should email the following documents in PDF format to by June 30, 2024. Please address your application to Dr. Vy Kim.

  • Statement of interest highlighting your reasons for applying to the fellowship
  • Updated CV
  • List of your credentials
  • Three letters of support

Applicants will be notified if they are selected for an interview. For additional information or questions, contact Sandra Mendonca, Training Program Co-ordinator at or 416-813-8626.

Contact Immunology & Allergy


Clinic appointments: 416-813-8156


General and education inquiries:

Sandra Mendonca



Clinical inquiries:

Antoniette Berlongieri



Clinical trial inquiries:

Alireza Berenjy


Division of Immunology & Allergy
PSC Tower, 13th Floor
Toronto, Ontario
M5G 2G3

Our history

Clinical Immunology was established at the hospital with the appointment of Dr. Robert Orange as Head of the Division of Immunology in 1971. During his tenure at SickKids, Dr. Orange’s work on mediators of inflammation had an significant impact on the emerging field of immunology. 

Dr. Erwin Gelfand, who took over the leadership of the Division after Dr. Orange’s premature death, can be credited with the creation of a world-renowned research and clinical centre thanks to his work in complement deficiencies and fetal thymus transplantation. He also enhanced the horizons of the field by hiring a group of clinician-researchers with expertise in rheumatology. 

Since Dr. Gelfand's departure in 1987, rheumatology has evolved into an independent division with the Division of Immunology and Allergy being merged into a single division in 1991 under the leadership of Dr. Chaim Roifman. Major achievements since that time include pioneering work in bone marrow transplants for patients who do not have a suitable donor in their family, exploration of the benefits of intravenous immune globulin for patients with immunodeficiency and autoimmunity, and groundbreaking research into the molecular and genetic bases of immune disorders. 

Back to Top