New allergist, RAST, IgE, tree nuts and reactions?

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Shan's picture
User offline. Last seen 3 years 17 weeks ago. Offline
Joined: 04/05/1999

DD saw a new allergist yesterday. I liked him better then our old allergist, although he seemed even more relaxed about peanut allergies! He told me to wait and watch dd if she had a reaction before I gave the Epi, unlike our old allergist who told me to give it at the first sign. Also, told me that driving to the hospital would be fine, probably wouldn't need an ambulance. He told me not too worry about giving Benedryl either. I'm not too sure I'll follow all that advice, but then again I quess it depends on the reaction? He also told me that the only thing I have to worry about putting dd in preschool is to make sure to bring her own snacks. That's it. He did listen to all my questions and seemed very concerned, but still had that overall attitude that I'm overreacting like so many before him...UGH! I give up on finding the perfect allergist. It seems this is something you have to take charge of yourself. ANYWAY, he did seem quite surprised when I told him our old allergist had given dd an oral challenge after the skin test was negative. I told him he told me that skin tests are never false negatives and I begged him for another test and all he would do was an oral challenge. Now that my Mom and I look back, our old allergist only did that test to make me happy. He didn't believe me at all, I don't think he would have normally done such a test. The new allergist said that testing for peanuts on skin tests can be hard. He really spoke against what our old allergist said which I found amusing since most doctors back each other up as I've seen so far. He ordered a RAST test for peanuts and walnuts, plus an IgE test? I wonder if she tests positive for walnuts if that means she'll be allergic to all tree nuts? Why would he only test for walnuts? Does anyone know what the IgE test will show us? I'm waiting for her ped to place an order form. I quess we have to go to the hospital to have the blood drawn. Anyone know how much blood they have to take? Is there a list somewhere with what all the results will mean? I had asked our old allergist for a RAST and he would not do it. The new allergist really wants a test which shows the peanut allergy. I asked him about molds and he didn't think that could be it. If the RAST comes back negative then he will do another skin test, but with actual peanut. Regardless, he wants us to come back in six months. Our old allergist told us we never needed to come back. How odd. One other thing, the new allergist told me dd's reactions sounded mild. What?!? She was swollen and red for at least a week, maybe even two and had hives all over her body, with a rash that lasted for a good month after that one bad episode since her old peds never told me to do anything about it. Hives on face, neck, arms, stomach, back and legs isn't severe? Just what is severe then? (JFYI-These two allergists work for the same practice! LOL) Shan

Diane's picture
User offline. Last seen 3 years 17 weeks ago. Offline
Joined: 12/15/1999

Hi Shan; I've considered going to another allergist also. I took my dd 1 yr ago, when she had a reaction to one little *Reeses Peices*. I was told to just have my dd stay away from peanuts, given a Rx for epi-pens and sent on our merry way. No further appointments necessary. He did order a RAST test for peanuts and pecans. I guess the pecans was to see if she had a tree-nut allergy. She tested normal to that but on a scale of 0-6 she scored a 5 on the peanut test. They drew 2 vials of blood. The second one was in case something happened to the 1st one we wouldn't have to go through the agony of drawing it again. She was only 2 yrs old then and it was a nightmare. How old is your dd? I don't know what the IgE test means that you mentioned but her test results did show her antibody level for pecans and peanuts. There were five on the scale: absent or undetectable level, low, moderate, high, very high. Hers was absent for pecans and high for peanuts. I'm guessing that that explains the IgE level. Does anyone else know for sure? Since the allergist didn't ask us to come back, I never had the test results explained. His office just called to say that she tested positive. I asked them to fax me the results. My dd also was covered with hives when she touched PB and her face and eyes were swollen; one of them almsot completely shut for 2 days.And a very, very runny nose! I remember her going through an entire box of tissues in two days! I'm glad you like this allegist better;it's funny that they are from the same practice!

Tammy James's picture
User offline. Last seen 3 years 17 weeks ago. Offline
Joined: 06/01/1999

Hi Shan!
Maybe I can help with the IgE test. Our son just had a RAST done for environmental allergies, peanuts (which we already knew about) and the IgE. From what I've been told, the IgE levels tell you how prone you are to having allergies in general. (Someone please correct me if I'm wrong.) The IgE scale goes from <18 - >158. Our son's was 383. The scale on the others went from 0 - >18,000. Our son's peanut was 48,292. Not that those numbers mean a whole lot as far as reactions go, but they do show a serious allergy, and a very high propensity to have allergies in general. I think they took 2 or 3 vials of blood, but our son was tested for more than what your daughter will be tested for. As for the new allergist's take on the peanut allergy... TRUST YOURSELF. He sounds a bit too relaxed about it for me, and reminds me of one of our peds who feels the Epi isn't needed until the person is struggling to breathe or is nearly passed out on the floor. Needless to say, I took a mental note of what he said... a note to remind myself not to discuss the peanut allergy with him again, nor to trust anything he says about it in the future. Don't worry, he's only one doc in a practice of over a dozen, and we see them all! And we have a good allergist! Best of luck to you, and be prepared with questions for your allergist on the day you review the results!

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