Skin testing...any risks?

My son did have a reaction to skin testing. We were retesting him for peanuts. I was concerned and the dr. decided to dilute the peanut protein (1 part peanut protein to 100 parts water). He got a hive at the site and then shortly after tightness in his throat. We were shocked that he still reacted. I won't ever do the skin testing again. We will stick to blood tests from now on. Many people have had no problems however. It is a tough decision. My son did very well with the blood test. Welcome to the boards!

[This message has been edited by PattyR (edited January 03, 2001).]

I have had skin testing lots of times without a reaction. They always dilute it as much as possible. I have never even thought about having a reaction to a skin test. At least if you do have a reaction, you're in a pretty safe place at the allergist! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

My first test in 1961 was traumatic. The Dr. administered 100 scratches. I reacted to 95. My sister and I were left unattended while waiting for a reaction. At five years old the memory of the Dr. returning to the room still is clear. I was nodding out, loosing consensus when I saw him hit the intercom and like right out of the movies he yelled "NURSE, GURNEY RM.3 STAT." I was rushed to the emergency room at the adjacent hospital. I'm told I had no vital signs for the first minute or so and how they got me back with Epi.

My second skin test, 30 years later was in the hospital and supervised. The test was for only five allergens, all nuts/legumes. These tests used much lower levels of the allergen than in the "old days", I was told. He made the scratches and said I should sit quietly for 10 to 15 minutes. 45 seconds into the test the Dr. almost in a panic said "ok that's enough" cleaned the test area got me some Benadryl and monitored my vitals for the next half-hour.

I've mentioned before my hyper-sensitivity, including airborne and I don't like to be a fear monger but with these allergies as in life there is danger in everything we do.

Dan

My three year old may need to be retested. I would like to know how severe her peanut allergy is. All Childrens hosp. suggests skin testing and maybe a challenge to peanuts. I have not decided how to handle it. We have only had blood tests so far at 1 1/2 years of age. Any seggestions woulld be appreciated. Thanks Miles

I would definitely advise against skin prick testing and this is only from the advice that I received on this board when I was going to have my PA son allergy tested. There is the risk that they can have a reaction, including an anaphylactic one. Based on this information, I decided NOT to have him tested for a peanut allergy, as we already know, for sure, that he has a life threatening allergy to peanuts.

However, when it came to the actual testing, the serum was mixed in such a way, that the actual peanut product serum did have to be placed on his skin. As soon as the nurse told me this, I asked her if they had Benadryl and an Epi-pen on hand in case there was any problem. Then, she did NOT prick the skin where the peanut serum was. He did end up with a reaction on his skin simply because of the serum being placed on it. That confirmed for the allergist that he was, in fact, PA.

Now, it was only because I was so unclear about what to do and came in here and posted and received great response and advice that I decided against having him tested for PA. Actually, I only had him allergy tested because his younger sister was going to be tested for PA.

Then, when the test results came in, I was back in here posting, all dazed and confused, because, as it turned out in the end, he had, I believe 5 FALSE positives. So, for a couple of months I thought he was allergic to 5 items that he actually isn't allergic to.

I understand that you need to have your child tested. I would suggest blood testing. Me, I don't think I'm going to consider it again for quite some time. I feel I already have my answers.

Please let us know how it goes. Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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Cindy-

I did not realize that there is a distinction between allergy testing (without priking the skin) and skin testing where the skin is punctured. My son was recently tested for walnuts, eggs and peanuts. Where the egg serum dripped down his back you could actually see small hives forming. The same happened with the peanut serum. The sizes of the welts where the skin was punctured differed in size considerably. The welt for egg was much, much larger than for peanuts. I was told that measuring the size of the welt for eggs over time (assuming they decrease over time) is an indication that he may be outgrowing his egg allergy.

My question is this...I have read postings on this site where someone claims to have actually had their son "outgrow" his nut allergy. Do you know of any instances where the decrease in the size of a hive for peanuts may point to this possibility. Also, what do you mean when you say that your son had 5 "false positives"? How did you know the results were positive?

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Cindy-

sorry, my last question is How did you know the results were false?

Liza, when my son had the skin prick testing done, he absolutely wigged out and had to have the tests done on his back. I almost forgot about this when considering his results. He tested positive for walnuts, eggs, trout, latex, and dog hair.

I wasn't concerned about the walnuts because we avoid tree nuts anyway. I knew that he wasn't allergic to eggs as he eats them all the time with no problem. The trout and dog hair were not much of a concern to me. However, the latex one was actually quite frightening.

The allergist did not provide me with any test scores, he just said that Jesse had tested positive for these things.

I think it took about a month for the results to be forwarded to my family doctor. The allergist concluded that because my son was ATOPIC (allergies, asthma, ezcema), the results were probably false.

Of course, I didn't know what this new "label" meant and came in and got a great response from people about what ATOPIC meant.
How this comes into play re his results is that Jesse has ezcema on his back. The ezcema on his back COULD provide false positives to allergens.

Then, I had to wait about another month before I could actually speak with the allergist because I wanted the exact test scores and I wanted to know what he thought.
It turned out that Jesse had only scored 1 on each of the 5 items and because of the ezcema on his back the allergist concluded that they were false positives. Had he been tested on his arm, as his sister was, where he has no ezcema, the results would have been considered more conclusive.

He went on to say that the only thing that Jesse was allergic to as far as he could tell was peanuts. This was because of the reaction he had on his skin by just having the serum in contact with his skin.

I must say that it was all terribly confusing and actually frightening when he tested positive for latex (you can have repeated exposures to it before you have a reaction, which, of course, could be anaphylactic).
I can only say that I was able to work through each step of what I consider now a frustrating experience (especially because I really didn't NEED him tested) because each time I was provided with new information, I came in here and posted.

I came in and posted the day we went to the allergist and I was originally told that he had the 5 allergies. I came in again to find out what atopic was. I came in again finally to say that they were false positives and why. It was through the terrific response from PA parents that have been through allergy testing that I was able to decipher all of this information.

My family doctor, in particular, didn't really seem concerned about the latex allergy and only told me to speak with the allergist.
He simply didn't want to deal with something that he had referred off to a specialist. This is an attitude that has irked me more often than not (even to-day when I saw him about something totally different).

I'm not saying that one shouldn't listen to family doctors, allergists, pharmacists. What I am saying is that if I am not clear about what I have been told, or if I have been told nothing (see my Hold to the Count of 15 thread under Living with PA re Epi-pens), I really appreciate the input of other parents here. They may have better family doctors or allergists. They may have more experience and education. I appreciate each and every person that helped me to sort this out.

I liked the final conclusion. My son is PA (I knew this already so I wasn't hopeful that he wouldn't be simply because of an allergy test) and my daughter is non-PA.

I hope this helps a little bit. What I really suggest you do, if you can and feel like it, is simply post each individual question you have re the testing and see what response you get. For example, I did post about skin prick testing versus blood testing to see why there was a difference and when you would use blood testing over skin prick testing.

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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Liza - I found another thread on this site dealing with experiences in skin testing that you might find helpful, just click on the link:
[url="http://uumor.pair.com/nutalle2/peanutallergy/Forum18/HTML/000061.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum18/HTML/000061.html[/url]

Also, I hope I'm not out of line, speaking for Cindy, but to answer your question on her son's false positives - I believe she knew they were false, because he has always eaten the foods in question with no difficulty at all. False positive are much more common in skin testing than false negatives. My cousin tested 2+ for almonds, something she eats ALL the time. If you have an actual reaction to a food, then get a positive skin test result - that pretty much guarantees you're allergic to it. If just the skin test shows a hive, and you've always eaten the food with no trouble, it's likely a false positive result. Hope this helps! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

We just had our three year old son tested for twelve different types of tree nuts. (We will get the results in three weeks to a month.) This was done by drawing blood. They took three small vials. He was a little trooper and only said ouch when they first put the needle in. We absolutely did not
want skin testing done because of the risk of anaphylaxis and because we also did not want to expose him to anything that he may not have been exposed to. Also the ideal if pricking his skin with several substances that we don

Mom to Cayley, definitely it was fine that you answered for me. As you know, the only one I was terribly concerned about was the latex one. Then I realized that bottle nipples are made of latex and pacifiers are made of latex. So when I really thought it, Jesse had had repeated (2-1/2 years with the bottle each day, 3 years with the pacifier each day - I know both are awful [img]http://uumor.pair.com/nutalle2/peanutallergy/redface.gif[/img] ) exposures to latex and still had not had a reaction.

After FINALLY speaking with the allergist, I was fine. Otherwise, I was going to have a blood test arranged for the latex only.

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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Cindy,
When your son tested "false positive" to latex did your doctor ask if Jesse could eat bananas and avocados? I read somewhere that the 3 are related. I know when Nick received his prevnar immunization they asked if he had a latex allergy or was allergic to bananas/avocados because if he was he wouldn't be able to receive the prevnar. Just curious. Kim I

KIM I, when the allergist told me what Jesse had tested positive to, including the latex, he also gave me a list of food items that may be of some concern. Of course, disorganized me, I can't find it. I especially had wanted to find it when Cayley's Mom did the wonderful thread under Living with PA about If you're allergic to this - avoid this (not the exact wording). It was a wonderful thread and I wanted to be able to add to it if I could from the list the doctor had given to me. So, yes, probably those two items were on there.

Now, when we went to have our flu shot this year, which is something that was free this year to all people in Ontario (the children had gotten it last year regardless because of their asthma), I still didn't know that Jesse's allergy to eggs (I think I may have left that out above, I'm not sure - brain blips again) was a false positive so I did tell the doctor that was administering the flu shot. If you have an egg allergy you are advised against receiving the flu shot. I told the doctor even though I was fairly clear that Jesse wasn't allergic to eggs.
He had wanted us to wait an hour for observation but the nurse told him that we lived right next door so that it was okay if we left. It was.

Darn, I really wish I had that list. Sometimes my mind boggles me - why wouldn't I have kept it until I at least confirmed that the results were false?

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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Ask your Dr about him/her administering a dose of Benedryl prior to the test. It tends to mask some symptoms, but the reactive process is lessened.
As far as the value of the skin tests per se, I would much rather have a reactive child in a clinic with trained staff and medication on hand, as opposed to being on my own.

lindaslade, welcome! It was interesting to see this particular thread raised again to-day. I did find the list of foods that the allergist had given to me and I posted them under Cayley's Mom's cross-reactive allergens thread under Living with PA.

Also, lindaslade, how soon before the skin testing can you dose with Benadryl? It has always been my understanding that you have to not take ANY antihistamine for FOUR DAYS prior to testing. What I did do was give my son his Claritin as soon as he got home and that helped with the mess that his back was after the skin prick testing.

I also wasn't clear what you meant about having your child or yourself tested in a clinic with trained personnel versus on your own. I'm not sure but I don't think any of us have actually tried to confirm a food allergy (or any other allergy) by attempting some sort of test on our own. Some of us, unfortunately, have found out that our children were PA the first time they tried a peanut product but that wasn't testing.

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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