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Peanut test numbers

2 replies [Last post]
By RBF on Wed, 03-12-03, 18:54

We have had conflicting test results. One RAST test didn't show a peanut allergy and another showed number of 5.60 or so. My question is: How did you know your child had a peanut allergy-did you see a reaction after food was given? (My son only had a tiny taste of peanut butter and did NOT react.) Second question, what numbers did your children get on the test and how does correlate to the reaction. Thank you

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By MeCash on Wed, 03-12-03, 20:43

Let's see. My son and daughter are both PA. My son wasn't dx'd until he was over 5. He had been asthmatic and in and out of the hospital/after hours clinics nearly weekly for five years. The last attack was brutal, and we finally left our insurer in disgust and took him to an allergist. He tested 4++ allergic to peanuts on the skin prick. The RAST test came back as a 2.66 or something like that. The scale our allergist used was from .00 - 9 with anything above .33 being allergic. He is considered 'moderately' allergic.

I think the numbers are irrelevant. If he were .33, I would be just as diligent. But, I can see you being confused by the conflicting tests.

My son reacted 'respiratory' wise all the time to peanuts in the environment and in the foods he ate until we eliminated them. He is no longer considered asthmatic.

My daughter has never been RAST tested (as I think it's unnecessary), but did test positive on the skin prick, which I already knew she would. When she was only 8 months old, I put Banana Boat Baby Boat Hypoallergenic SPF 36 sunscreen on her. Her face and arms swelled up angry red within a couple of minutes and scared the crap out of me and my husband. We rushed her back to our hotel, bathed her and gave her benadryl (thank God my son IS PA, as we always have benadryl around!) She cleared up fairly quickly, but there was no indication it was 'peanut related' at the time. Then last year, when she was at the hospital for a horrible strep infection in her lymph node, the doctors gave her peanut butter and crackers (imagine THAT!!! In a pediatric unit, at that!!) and she soon reacted with hives around her mouth and irritability/diahrea later. I didn't make the peanut connection until later (my husband gave her the crackers), because she was on IV antibiotics and they just gave her a new one and the hives went away after a while with no other complications. Of course, I did mention the hives to the doctor, who blew it off. Later, when we got her home (6 days), my cousin brought her a small peanut butter cracker, which she LOVED, but which immediately caused her lips to swell and face to break out in hives. THEN I made the connection.

I know that considering the fact that I have one son who is PA that I should have figured it out sooner and I kick myself over it, but I guess I was so stressed over being in the hospital with her in the first place that my brain wasn't working correctly.

Now we have a EpiPen Jr for her and a PA diagnosis, and even though I am not inclined to think she has any of the other problems my son has, she will never step foot in a public school so long as *I* live.


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By Corvallis Mom on Wed, 03-12-03, 22:13

I know that there are a lot of threads on-site about what different tests and numbers in those tests mean, but frankly, I truly think that I have to agree with our allergist (the new one) who says that regardless of test results, neither skin tests nor blood tests can completely gauge an allergy (or a lack of one) since there are too many factors involved. I say this (and I may get flamed) because we went CRAZY over blood test results which seem to indicate that our daughter has mild to moderate allergies to apples, milk, oats, and a host of other things that she has NO clinical symptoms to...simply elevated antibody levels... this doesn't automatically translate into interaction with mast cells (causing a reaction). We have agreed with our allergist that if a skin test is negative and RAST results are less than "moderate to severe" we will ignore the antibody levels until we have reason to think that there is a real problem. If the skin test is negative, according to our doctor, you still have about a 5-10% chance of having the allergy if the blood test is positive, but the only way to know it is to challenge. With peanuts, though, you would *never* want to do that challenge yourself.
If you don't see any problems when you *know* exposure has occurred, it might be worth exploring with your allergist how "real" an allergy is. With PN, there is usually NO DOUBT about the real allergy, even though reactions are unpredictable. Most of us here on this site (again, I may be wrong) didn't find out about the allergy via tests at all. We found out the hard way.

That said, to answer the original question, our daughter has never been skin tested for PN (and never will be as far as I can tell). I think that our allergist reviewed her history more thoroughly and decided that after all there may be some people who just should not be skin tested. She has had RAST evaluations four times. The first was to evaluate the "severity" of her allergy after her first exposure and resultant anaphylaxis. The result was a RAST of 20 (which is class 3, I think) but then a year later, without any known intermittent exposure, she tested at >100 (class 6) and has tested out of the linear range of the test ever since.
She is contact and aerosol sensitive.

[This message has been edited by Corvallis Mom (edited March 12, 2003).]

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