Episode Details

At what point does a “routine” sinus or ear infection become a warning sign of immunodeficiency? In this episode of the BackTable ENT Podcast, board-certified allergist-immunologist Dr. Basil Kahwash explores the intersection of immunodeficiency and otolaryngology with Dr. Lauren Gunderman, a pediatric immunologist at Seattle Children’s Hospital. Learn why ENTs should remain vigilant for underlying immune disorders, and how to manage suspected immunodeficiency.

---

SYNPOSIS

The conversation reviews common signs and symptoms of immunodeficiency, key elements of the diagnostic workup, and when ENT physicians should consider referral to immunology. Dr. Kahwash and Dr. Gunderman discuss the role of family history and genetics, as well as current management strategies, including antibiotic use, immunoglobulin replacement therapy, and lifestyle modifications. Throughout the episode, Dr. Gunderman emphasizes the importance of multidisciplinary collaboration between otolaryngologists and immunologists to improve outcomes for patients with recurrent or severe infections.

---

TIMESTAMPS

00:00 - Introduction
02:45 - Understanding Immunodeficiency in ENT
08:20 - Common Immunodeficiencies and Indicators
11:02 - Basic Immunology Refresher
22:13 - Initial Diagnostic Workup
25:05 - Challenges in Allergy and Immunology Testing
27:57 - When to Refer to an Immunologist
34:01 - Antibiotic Stewardship in Immunodeficient Patients
46:07 - Advances in Diagnosing Immunodeficiency
50:31 - Final Thoughts and Takeaways

---

RESOURCES

Lauren Michelle Gunderman, MD
https://www.seattlechildrens.org/directory/lauren-michelle-gunderman/