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I know this has been discussed before, but maybe not quite in this way. Before Ben was diagnosed with PA/TNA, we used to give the kids nuts all the time. Ben never cared much for them (but only reacted to walnuts and that's when we found everything out.) Eliza liked pretty much all nuts and never had a problem. Once Ben was diagnosed, we decided to keep Eliza off nuts until she was 4 or 5. Well she'll be off to preschool in the fall and she'll be 4 1/2 then. With such a high rate of false positives on these tests, I'm not sure I want to get her tested. She never showed any signs of being allergic, and isn't really atopic like Ben is. (She has a problem with gnat bites in the summer but that's about it--no eczema, seasonal allergies, etc.) So, I don't really want to get her tested, but it doesn't quite feel right to send her off to preschool and let her eat anything after 2 yrs of no nuts. If I got her tested and it was negative, great. But if it were positive.... So should I just skip the testing based on no history of reaction? Or should I take my chances with a 70% false positive rate on skin tests and if it's positive go on to CAP RAST and oral challenge? Any comments? Just writing this out it sounds reckless not to get her tested, but it almost seems ludicrous to do the testing since she's "obviously" not allergic.
I'm one of those who have responded to this type of question before. My oldest is PA, my youngest (now 3 1/2) has been skin tested once for peanut (and other suspected foods), but was negative to everything. However, the skin test was most likely his first exposure to peanut, so I'm not really counting it as correct.
He will probably attend preschool when he's 5, and before then we'll probably do an actual exposure in the allergist's office, as well as another skin test, if not blood test. (He doesn't *seem* the least bit allergic, either, except for a bit of eczema.)
Hate the thought of it all, but it should be done, I guess.
I'm not sure how we'll handle the issue of him not getting residue on his brother, but if his brother can attend school safely with all the kids there having their PB, then he will probably be able to, too. If he wants to. So far, he's never eaten it. I doubt he'll WANT to when he understands fully what it could mean for his brother.
Good luck with your decision.
Take care,
Tammy
Bensmom, where did you get that figure of 70% false skin tests? I'm curious. If this is true, it makes me wonder about my (quasi) reaction free daughter!
redtruck, that statistic is from Dr. Wood, a pa expert at Johns Hopkins. One caveat--I'm not sure if it's 70% false pos for everyone or 70% false pos for atopic people. I think it was for everyone. He said negative skin prick tests are generally accurate, so I guess they're good for ruling things out. What is your daughter's reaction history?
My 6 yr old avoided any nuts until age 3 when she was allowed to try some. She had some toast with pb and didnt like it after one bite. She had some hazelnuts and desserts with hazelnuts and almonds and was ok. A few months later, my wife let her try some walnut and she had a few white spots around her mouth. After that, we had her skin tested and was positive for peanuts and walnuts. she has since avoided all nuts and has been reaction free (we think)...
i say i think because she has thrown up a few times over the past 3 years which could have been a result of a reaction or any other million causes anyone has for throwig up!
Thanks for the interest Bensmom!
redtruck, now I remember your daughter's situation. I forgot how similar it is to Ben. He also had a small reaction (bump on his lip) to walnuts. He tested positive to everything although he'd eaten almonds and probably hazelnuts before with no problem. He had also tried pb but didn't like it, but no reaction. It might be worth getting her a CAP RAST, but don't get your hopes up. Ben was over 100 on CAP RAST (off the charts--should react to minute amounts).
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Bensmom,
My daughter has never been tested either.
She never reacted to the 1/2 choc.chip with minute pb that my son did, but because they are young still and close(kissy face close) I wouldn't want her eating it anyway.
So, even if you don't get her tested and assume she isn't allergic, send safe snacks to school(if it's not a peanut/tree-nut safe school) so that you don't have to worry about her contaminating her brother.
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