Paediatric allergologist in Latviawhere to get treatment, how to verify certification, what this doctor does

A paediatric allergologist diagnoses and treats allergic disease in children. In Latvia the field overlaps heavily with paediatric pulmonology, since asthma, allergic rhinitis and atopic dermatitis often occur in the same child.

• Asthma and recurring airway symptoms
• Allergic rhinitis and eye inflammation
• Atopic dermatitis and other skin manifestations
• Food allergy
• Drug allergy, including children who have had problems with vaccination
• Reactions to insect stings

A family doctor or paediatrician is enough for one-off reactions that settle quickly. A paediatric allergologist is needed when symptoms recur, when treatment is not working, or when the specific allergen has to be identified.

The Children's Clinical University Hospital states that its allergology team provides the following:

Specialists from other fields are brought in where needed.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• Entry to the paediatric allergology programme requires a copy of a valid paediatrician certificate, or university confirmation of third-year residency in the base specialty "Pediatrs". For doctors without the paediatrics specialty the programme runs six years.
• Residency in paediatric allergology. The RSU programme runs 3 years, 198 ECTS, tuition 5,800 EUR per year, with 1 state-funded place in the intake, led by Ieva Cīrule. Programme page: RSU residency programme.
• The programme covers paediatric allergology and related fields: allergology, immunology, paediatric dermatology, otorhinolaryngology, pulmonology, laboratory medicine and intensive care.
• The state examination requires defence of a research project, written answers to three theory questions, and three clinical scenarios.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points, at least 60 per cent tied to the base specialty, plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• The child's age. Spirometry is usually possible from age 5 and oscillometry from age 4, so the test options differ for younger children.
• Tests on site. If skin or provocation testing is planned, check whether the provider runs them and whether they are done under medical supervision.
• Immunotherapy. Desensitisation is long-term treatment, so the provider's location and availability matter.
• Asthma and skin symptoms together. If the child has both airway and skin or food symptoms, a specialist working across both saves referrals.
• Second opinion. A child's legal representative may freely choose the doctor and institution.

• If spirometry is planned, salbutamol (Ventolin) should be avoided for at least 6 hours before the visit, and combined medicines such as Seretide or Symbicort for 24 hours, where the child's condition allows.
• If skin allergy testing is planned, antihistamines should be stopped at least 5 days before the visit, where the child's condition allows.
• Where food allergy is suspected, keep a food diary recording what the child eats and whether it triggers symptoms. If the baby is breastfed, the mother keeps a diary too.
• Bring information on the child's health, the medicines they take, and relevant family health history.
• After testing the doctor sets a treatment plan, which may include medication, allergen avoidance and immunotherapy.

Children under 18 are among the groups exempt from patient co-payments, so a state-funded paediatric allergology consultation on referral costs the family nothing. A private visit is paid by the parents or an insurer, and tests are charged separately from the consultation.

• Patient co-payment for a child under 18Price EUR: 0.00Source: NVD
• State-funded consultation on referralPrice EUR: 0.00Source: NVD, exemption for children under 18
• Private paediatric allergology consultation and testingPrice EUR: per clinic price listSource: Premium Medical

The specialty body is the association "Latvijas Bērnu alergologu un pneimonologu biedrība" (Latvian Association of Paediatric Allergologists and Pulmonologists), registration number 40008061291, registered address Vienības gatve 45, Children's Clinical University Hospital, ward 18, Rīga, LV-1004. Contacts: Ineta Grantiņa and Elīna Aleksejeva, emails ineta.grantina@bkus.lv and elina.aleksejeva@bkus.lv.

Adult allergology is represented by a separate association, "Latvijas Alergologu asociācija", registration number 40008098985.

Certificates are issued by the Certification Council of the Latvian Medical Association, founded in 1988. The sector regulator is the Health Inspectorate.

If you have doubts about the care a child received, raise them first with the institution's management, which must operate a complaints and suggestions system. If that does not resolve it, the child's legal representative may submit a written complaint to the Health Inspectorate no later than two years after the alleged infringement. It is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.