ALPIMS • Immune & Inflammatory
What feels closest right now?
Itchy, congested, reactive—or dealing with a familiar flare?
Choose one description for a small starting point. You do not need to know the cause before asking for help.
Begin with safety and one manageable support.
Difficult or noisy breathing, tongue swelling, throat tightness, a hoarse voice, persistent dizziness or collapse can indicate a severe allergic reaction. A rash may be absent.
Use a prescribed adrenaline device immediately if available, and call 000 in Australia. Follow your ASCIA action plan.
Lie flat and do not stand or walk. If breathing is difficult, sit with legs outstretched. Antihistamines do not replace adrenaline for anaphylaxis.
ASCIA: Anaphylaxis and emergency treatment →A small check-in
Open whichever fits. Several descriptions may be relevant.
My nose or eyes are irritated Sneezing • itchy eyes • runny or blocked nose
If there is an obvious exposure, reduce it safely. Use your usual rhinitis or allergy plan.
Avoid rubbing irritated eyes.
Allergy or something else?
Pollen or dust-mite allergy can cause these symptoms. Irritants, non-allergic rhinitis and infections can produce similar difficulties.
A pharmacist or clinician can advise on suitable treatment and correct use of nasal sprays. Mention medication side effects or sensitivities.
Persistent symptoms deserve assessment. Eye pain or changes in vision need prompt medical advice.
I am coughing, wheezing or feeling chest tightness Breathing symptoms • possible asthma flare
If you have asthma, follow your asthma action plan and use your prescribed reliever as directed.
Severe breathing difficulty, difficulty speaking or symptoms not responding to your plan need urgent help. Call 000 for an emergency.
Important distinctions
Breathing symptoms can have several causes. Do not assume they are asthma or anxiety without assessment.
Sudden breathing difficulty after a possible allergen may be anaphylaxis. Follow your allergy action plan; an asthma reliever does not replace adrenaline.
Ask for a review if you need your reliever more often, wake with symptoms or cannot do your usual activities. Inhaler technique and preventer treatment may need checking.
My skin is itchy, dry or irritated Eczema • dermatitis • discomfort after a product
Stop using a newly introduced product if it appears to be irritating your skin.
For familiar eczema, follow your skin-care plan using products you already tolerate.
Keep the approach simple
Irritant dermatitis, contact allergy and eczema are different conditions. A clinician can help identify which treatment fits.
Fragrance-free products may be useful, but no product is suitable for everyone. “Natural” does not mean non-irritating.
Seek prompt care for rapidly worsening redness, warmth, pain, weeping or fever. A widespread blistering rash, especially after a medicine, needs urgent assessment.
I have hives, flushing or repeated reaction episodes Raised itchy welts • redness • symptoms occurring together
If breathing, throat symptoms or collapse are involved, use the emergency guidance above.
Otherwise, follow your agreed reaction plan and seek advice if the episode is new or changing.
Where does MCAS fit?
Hives or flushing alone do not establish mast cell activation syndrome (MCAS).
MCAS assessment considers recurrent episodes, objective evidence of mast-cell mediator release and response to appropriate treatment. Other causes need consideration.
If safe and useful, a photograph of a rash and a brief note about timing may help assessment. You do not need to monitor every sensation.
Ask your specialist whether any testing needs to be arranged during an episode.
A food or medicine seems connected to symptoms A possible reaction • an uncertain trigger • side effects
Note what you took or ate, the timing and the symptoms. Ask a clinician or pharmacist what to do next.
Do not deliberately retry a suspected allergen or a medicine that caused a significant reaction.
Protect nutrition and treatment
Food allergy, intolerance and medication side effects are different. Timing can provide a clue, but it does not confirm the cause.
Avoid removing many foods without suitable advice. A dietitian can help maintain nourishment while a specific concern is investigated.
For a possible medication reaction, seek advice about the next dose and alternatives. Severe symptoms require emergency care.
Antihistamine benefit alone does not prove allergy or MCAS. Discuss sedation and other unwanted effects with your pharmacist or prescriber.
Fragrance, smoke or another exposure is bothering me Irritation • headache • breathing or sensory discomfort
Move away from the exposure if you can do so safely. Ask for a fragrance-free or smoke-free space.
Follow your breathing or reaction plan if it applies.
Support without assuming a mechanism
An exposure may irritate airways or skin, trigger headache, or create sensory distress. Symptoms do not automatically establish an immune reaction.
A practical adjustment can still be helpful while the cause is assessed.
Choose changes relevant to your known triggers. Allergy-friendly product labels are not a guarantee of suitability for MCAS or environmental sensitivity.
I have a diagnosed inflammatory or autoimmune condition A familiar flare • changing symptoms • treatment questions
Follow the guidance agreed with your treating team. Contact them about new symptoms or a significant change.
Do not change steroids, immunosuppressants or other prescribed treatments on your own.
What deserves separate assessment?
A new symptom may be a flare, infection, treatment effect or another problem. It should not automatically be attributed to your existing condition.
If you take medicines that suppress immunity, follow your team’s advice about fever and possible infection. Seek prompt advice if you feel newly unwell.
Your care plan can also include practical help, rest and support with the emotional impact of living with illness.
I am not sure—or several things fit You can ask for help without choosing a diagnosis
What is happening now? Is it familiar, or new and different?
Choose a safe practical support and seek advice about persistent, recurring or changing symptoms.
A brief note for your appointment
- What symptoms occurred together?
- When did they begin, and how long did they last?
- Was there an exposure, illness or new medicine?
Include what helped and any treatment side effects. Let your clinician choose appropriate investigations.
What does the Immune domain include? Different conditions—different assessments and supports
This ALPIMS domain draws attention to allergy, inflammatory conditions, autoimmune illness and diagnosed mast-cell disorders.
These are not interchangeable diagnoses, and they do not all involve the same mechanism.
Irritation, sensory sensitivity and food intolerance may overlap with these experiences without necessarily being immune-mediated.
The purpose is to notice relevant concerns and find appropriate assessment—not to label every symptom as inflammation or MCAS.
Could one support help across several domains? Comfort • sleep • reduced demands • clearer care plans
Managing itchy skin may make sleep easier. Treating nasal symptoms may improve daily comfort. Reducing an irritating exposure may also make a setting easier to tolerate.
Clear action plans can reduce uncertainty and help others respond appropriately.
Emotional support can help with the burden of symptoms alongside medical care. Its usefulness does not establish a psychological cause.
What is one next step?
Follow your care plan, make one practical adjustment, or arrange assessment of a recurring concern.
Support should fit the condition, your tolerances and your available capacity.
Resources & further reading
ALPIMS is an organising framework, not a medical diagnosis. This check-in provides general information and optional support ideas. It cannot diagnose allergy, MCAS, autoimmune disease or the cause of a reaction. Follow your individual action plans and seek assessment for new, persistent or changing symptoms.