ENT & Allergy Specialists North KY

Adult and Pediatric Diseases of the Ear, Nose
and Throat and Allergy, Asthma and Immunology

KY (859) 781-4900 OH (513) 631-1044

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Allergy, Asthma and Immunology Department

Meet Our Allergy and Immunologists

 

Corey Clay MD Immunologist and Allergy Specialist

Corey Clay, M.D., Ph.D.

Dr. Clay received his M.D. and Ph.D. from Ohio State University and completed his residency at the University of Cincinnati Medical Center in 2013. He is board certified in Internal Medicine and received specialty training in Immunology and Allergy from the University of Cincinnati Medical Center and Cincinnati Children’s Hospital.

Dr. Corey Clay's Full Bio


Manuel Villareal, MD Immunologist and Allergy Specialist

Manuel S. Villareal, M.D.

Dr. Manuel Villareal practices Internal Medicine as an Allergist and Immunologist. He is a Diplomate of the American Board of Allergy & Immunology and American Board of Internal Medicine (ABIM); a Certified Physician Investigator and ABIM Geriatric Medicine specialist; and a Fellow of the American Academy of Allergy, Asthma & Immunology and American College of Allergy, Asthma & Immunology.

Dr. Manuel Villareal's Full Bio


Services We Provide:

Procedures We Preform:


Allergy Education and Helpful Links


Services We Provide

Asthma

A lung disease involving inflammatory, but often reversible airway obstruction. Symptoms may include coughing, wheezing, chest tightness, shortness of breath, nighttime awakenings due to chest symptoms and exercise limitation. Asthma affects more than 20 million people in the United States. About 70-80% of patients with asthma have allergies contributing to the cause of symptoms. Asthma tends to worsen as sinus allergy symptoms increase. There is often a genetic component and it tends to run in families. Common triggers of symptoms include weather changes, colds/infections, allergies, stress, chemical irritants, acid reflux, pollution and exercise. The evaluation includes a detailed medical and occupational history, physical exam, lung function testing, exhaled nitric oxide level measurement and peak flow evaluation. Treatment includes education, avoidance measures, medications/inhalers and possibly allergy shots. In children with sinus allergies, allergy shots have been shown to reduce the risk of developing asthma by about 50%. For patients with severe asthma, Xolair (omalizumab), Nucala (mepolizumab), Cinqair (reslizumab), or other newer options may be considered in the treatment protocol.

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Other lung problems

COPD is an irreversible form of chronic airway obstruction due to inflammatory and structural changes to the lung architecture.  It can involve emphysema, or breakdown of the smallest pockets of airway into larger and less-efficient blebs or pockets, or changes to the airway leading to mucus production, scarring and blockages. Smoking is by far the greatest risk factor for developing COPD. It is diagnosed by careful history, lab tests and lung function testing.  Often, patients may suffer from COPD/asthma overlap with features of both.  Allergists are adept at distinguishing and managing certain causes of chronic lung disease including COPD, allergic bronchopulmonary aspergillosis (ABPA), hypersensitivity pneumonitis, eosinophilic pneumonia and others that are even less common.

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Allergies

With true food allergy, the immune system reacts to certain foods and symptoms may include itching, trouble breathing, swelling, stomach pain, hives or loss of consciousness. It is important to distinguish between food allergy and food intolerance. While food allergy typically starts early in life, it can develop later and affect people of all ages. It is often found in association with asthma, nasal allergy, eczema and eosinophilic esophagitis. After a detailed medical history and physical exam, the proper testing is chosen to aid in making the diagnosis. We are able to test for a large panel of food allergens including the most common offenders such as dairy, eggs, wheat, soy, seafood, and nuts in addition to meats, fruits, vegetables, yeast and certain spices. In some cases, particularly for peanut allergy, recent advances provide for desensitization strategies to develop lasting tolerance. If food intolerance is suspected, we offer education and dietary guidance to help reduce symptoms. For more information, Click Here

Food Allergy & Food Intolerance

With true food allergy, the immune system reacts to certain foods and symptoms may include itching, trouble breathing, swelling, stomach pain, hives or loss of consciousness. It is important to distinguish between food allergy and food intolerance. While food allergy typically starts early in life, it can develop later and affect people of all ages. It is often found in association with asthma, nasal allergy, eczema and eosinophilic esophagitis. After a detailed medical history and physical exam, the proper testing is chosen to aid in making the diagnosis. We are able to test for a large panel of food allergens including the most common offenders such as dairy, eggs, wheat, soy, seafood, and nuts in addition to meats, fruits, vegetables, yeast and certain spices. In some cases, particularly for peanut allergy, recent advances provide for desensitization strategies to develop lasting tolerance. If food intolerance is suspected, we offer education and dietary guidance to help reduce symptoms.

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Drug Allergy

A person can be allergic to any drug, drug-additive and even to vaccines and hormone-replacements. The most common offenders include antibiotics, seizure medications and pain medications such as aspirin and ibuprofen (NSAIDS). We carefully evaluate all patients, offer testing when appropriate and perform drug challenges in our clinic when needed. Penicillin allergy testing is now commercially available and we routinely perform this testing in our clinic. Less than 15% of patients who are considered to be penicillin allergic are actually allergic to penicillin. In extreme cases, chemotherapy for example, we use protocols to deliver medications in ways that may not otherwise be tolerated for specific patients.

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Anaphylaxis

A severe, systemic and potentially life threatening allergic reaction. Symptoms may include hives, swelling, nausea, loss of bowel control, trouble breathing, dizziness, or loss of consciousness due to a drop in blood pressure. There are a number of causes but the most common include medications, food, insect stings or underlying mast cell disorders. After a detailed medical history and physical, allergy testing may be used to help identify a trigger. Treatment involves education of avoidance measures and an Epipen device with an anaphylaxis action plan for emergency situations.

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Angioedema

Swelling of one or more body parts. It can develop due to allergic causes, medications, auto-immune causes or enzyme deficiencies/dysfunction. It may be associated with or without hives. Symptoms can last from minutes to days. A number of treatment options are available after the correct diagnosis has been made.

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Eosinophilic Esophagitis

Inflammation of the esophagus (swallowing tube) due to allergies or immune dysregulation. Symptoms may include chronic reflux/GERD (that does not adequately respond to acid lowering medications) or the sensation of food getting stuck when trying to swallow. It is often associated with environmental and/or food allergy. We often work with a gastroenterologist in the evaluation and treatment of this condition.

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Allergic Conjunctivitis

Watery, red, itchy, or irritated eyes. While there are a number of conditions that are associated with these symptoms, allergy is one of the most common causes.

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Contact Dermatitis

Skin rashes that develop due to physical contact with an allergic trigger such as poison ivy, jewelry/metals (nickel), cosmetics, perfumes or other chemicals found in a variety of purchased products or in occupational settings. Patch testing is used to determine the offending agent that leads to the development of this type of allergic rash. Treatment involves identification and avoidance of offending agents and topical/oral medications when needed. For metal allergy, when appropriate, we offer comprehensive pre-surgical testing to help guide decision-making. We also offer skin biopsies to help diagnose similar types of chronic rash that may not necessarily be allergic in nature.

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Hives

Also known as urticaria, these are itchy welts that can be either acute or chronic in nature. Acute causes may include food, medications, environmental allegens or infections. For acute urticarial, the cause may never be identified because hives may disappear as quickly as they appear. Chronic urticarial relates to hives that persist for weeks to months or longer. Causes are difficult to diagnose but are often associated with an auto-immune component, recurrent exposure phenomena, mast cell sensitivity to certain physical stimuli, or as a symptom of another disease process. There are a number of treatment options available for each patient, even those with the most severe symptoms. For severe hives we offer monthly Xolair injections, which is very effective.

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Atopic Dermatitis/Eczema

Atopic dermatitis is a form of eczema associated with environmental and/or food allergies in addition to inherited disorders with skin barrier and immune functions. While infants and children tend to be more affected than adults, this condition may develop at any time and affect people of all ages. It is associated with dryness, rashes, itching and infection. Symptoms typically start with itching, and then a rash develops (“the itch that rashes”). Treatment includes identification and avoidance of allergies, topical and oral medications, immunomodulatory therapies and possibly allergy shots.

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Immune Deficiency

People who experience chronic or repeated infections may have a genetic or acquired deficiency of the immune system. Infectious complications may develop early in life or manifest in adulthood. Repeated episodes of sinus infections, bronchitis, pneumonia, skin infections, warts, urinary tract infection or chronic gastrointestinal infections may be a sign of a immune deficiency. We also evaluate problems such as chronic non-cancerous lymph node enlargement, splenomegaly, vasculitis, and other forms of autoimmunity that can be indicative of a Apossible immune disorder. We perform both a quantitative and qualitative evaluation of the immune system and provide effective therapeutic options for each patient when intervention is needed.

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Chronic Rhinitis or Rhinosinusitis

Patients may be affected by either acute or chronic rhinosinusitis. This may involve actual viral, bacterial or fungal infection of the sinuses and is a common complication of allergic or non-allergic rhinitis. It may also involve structural problems in the nasal cavity (like polyps or septal deviation), medication side effect, irritant sensitivity, or immune dysfunction. Symptoms may include persistent congestion, sinus pressure, sinus headaches, ear fullness/popping/pain (Eustachian tube dysfunction), fever and post-nasal drip. Allergy is one of the most common conditions that leads to sinus infections.

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Nasal Polyps

Polyps are soft, non-cancerous growths that lead to nasal obstruction and poor air flow. They may develop as a consequence of environmental allergy, drug allergy, problems with innate immune function or for other reasons. A common consequence is the partial or total loss of the sense of smell. Nasal polyps are sometimes associated with asthma and aspirin sensitivity (Samter’s Triad). Polyps generally require surgical management as well as long-term medical management. Several exciting new options for treatment are available to discuss with your physicians.


Chronic Persistent Cough

Three of the most common causes of chronic cough include post-nasal drip, acid reflux/GERD, and asthma. Each of these conditions may have an allergic cause and it is important to have a thorough evaluation if you have a chronic cough or notice a seasonal pattern. Certain medications may lead to chronic coughing as well and these are reviewed by the physician. If the initial evaluation fails to uncover the cause of persistent cough, we can evaluate the vocal cords directly via rhinolaryngoscopy and evaluate for the more rare causes for persistent cough that include other lung disorders, eosinophilic bronchitis, paradoxical vocal fold motion, post-viral vagal nerve neuropathy, etc. Clearly, this can be a complicated problem, but our physicians have experience with difficult cases.


Stinging Insect Allergy

Allergic reactions to insects such as ants, wasps, bees, yellow jackets and hornets. The reactions can vary from large local reactions at the sting site to severe life threatening allergic reactions. We evaluate and offer treatment for this form of allergy, which alters the immune response and can be life-saving.

Mastocytosis

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Hypereosinophilic Syndrome (Blood Disorders)

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Eosinophilic Esophagitis

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