Peanut Allergy is the most prevalent food allergy in the US, where as many as 1.5 million people suffer from the disease (American Academy of Allergy, Asthma & Immunology). Peanut Allergy is the most common cause of food related death (Asthma and Allergy Foundation of America).
More Statistics...
You should discuss this with your allergist.
If you son is eating peanuts without reaction you can request a food challenge--which is the only way to determine a true food allergy.
Allergy testing by blood and skin prick can help--but can have false positives and should not be used alone to determine a food allergy if there is no history of reaction to the food or if an individual is eating the food without reaction.
See my most recent blog post here citing an article in the Wall Street Journal:
http://www.peanutallergy.com/news/food-allergy-news/wall-street-journal-...
Unfortunately we are currently stationed in Okinawa, Japan with the Marine Corps. It will be hard to get a second opinion especially since allergies was NOT the initial reason for our dr's visit.
My son's medical hx is complicated and none of it seems to make much sense. When he was just a baby, we concluded that he had a pretty strong milk allergy or intolerance. I had to stop breastfeeding and unfortunately had to put him on lactose free formula. After about 1 year, he no longer seemed to have issues with milk and has since been absolutely fine with all food products. About a 1 1/2 years ago, we were outside playing baseball with him and our older son when he got hit in the chest with a baseball. About 10 minutes later he went into anaphalaxis. We immediately took him to the hospital where, thank God, they got him under control without having to intubate him. After that episode, we had him allergy tested. The skin tests were fairly inconclusive to foods (very low-normal levels), though it did show a pretty large reaction to several kinds of grasses and to cats and dogs. Since that episode he's had no issues. We've had a problem with his ears/hearing and the doc's here wanted to do a trial on taking him off milk/eggs to see if that helped. At the same time, we ran another panel of blood allergy testing. The milk allergy came back normal but it showed a huge amount of allergies to everything from peanuts to potato's. All of which he regulary eats. The doc is very concerned for him to have any kind of peanuts/tree nuts and egg whites. He also wants to put him on SLIT therapy which is not FDA approved in the states, but he has been able to get it approved here in Okinawa, Japan. I do not want the therapy based on his history of no reactions to these food items. I don't understand why we'd put him through all that if it's not affecting him. From what I understand it could potentially trigger these allergens to affect him for the first few months.
Sorry to be long winded...I'm just frustrated and trying to find some answers!
Thanks for the help and I'll look into that article! Please let me know if you have any more thoughts!
Wow! It's a shame it is so difficult to get a second opinion (though I can understand why it would be!). In my uneducated opinion, it really sounds like you could use a second opinion. You've probably read the articles that have come out over the last year about children who've been diagnosed with multiple allergies, avoided all sorts of foods, only to learn later it was a misdiagnosis.
How about a food challenge? Do you have access to an allergist who has experience with food challenges? It's conceivable you may be able to rule out one or more of the allergies with a food challenge, if the allergist feels it is safe and appropriate.
Any chance you might come to the States for a visit (including an allergist visit) in the next few months? It sounds like you are really between a rock and a hard place. I wish I had more helpful information to share.
Best wishes,
Jennifer B
Unfortunately no, the don't have the capabilities to do the food challenge here. The doc was really pushing the SLIt therapy which I declined based on his lack of reactions to said allergies. In talking to his regular pediatrician, she agrees with us about the inadequicies of the test and I have since called to discuss how to get a second opinion-hopefully they'll be able to work with us on getting it done. While I don't feel he has any of the allergies the testing said he has, I also don't want to take a chance with his well being. I believe the only way to set the record straight is to get a second opinion. Thanks again for the help. I appreciate it very much.
Good for you--in situations like this, I really think you've to go with your gut. I bet I would do the same thing in your shoes. Hope they will work with you so that you can get a second opinion. Keep us posted!
Best wishes,
Jennifer B
Ditto on everyting BestAllergySites said above. I am curious--how did your son come to be diagnosed with a peanut allergy?
Hopefully my other reply can answer your question-and if you have any other information for me, I'd appreciate the help. We're in kind of a unique situation being based where we are. Thanks!
In reading your comments above, It doesn't sound to me like an allergy. Getting hit in the chest shouldn't be the trigger. There wasn't break in the skin, nothing was ingested. If he had been complaining of a stomach ache,or itchy etc... then yeah maybe it was a delayed reaction and it was a fluke that he got hit with the baseball. The other thing that I would consider since I have had to journey this road before with both my kids having nut allergies. Primary care doc even with the best intentions can misread tests. I had a doc tell me that the hives that my daughter got 20 min after taking PCN were just a reaction to a virus and to cont to give her the PCN. Her allergist tested her and said no way. One thing that you might be able to do is get virtual second opinion through the internet or mail. Just to add when they tested my daughter with the skin prick test she can up more positive to soy then peanuts. She still eats soy products I won't let her touch a peanut. The PCN tested came up very positive with the skin prick test but was negative with blood testing. Blood test can give you false negatives readings just like the skin test can give false positives. So you really need someone that can interrupt these test. If you are uncertain about foods then go somewhere you trust and have them do a food challenge. Allergies are confusing. I would always be prepared with your epi pen and xyzal until you know for sure.
Thanks for the info-I'm looking into how to get a second opinion while we're here, not sure how that's going to happen but I'm hopeful it will (I'm pretty stubborn too and I'll do whatever it takes!) I just don't want to take any chances with our boy and want more answers than what I'm getting.
We've done both skin and blood, and the blood we did twice. The initial dr wasn't concerened about his levels of food allergy but the doc here seems to think he's got some serious issues. I just don't get it-I'm more inclined to go with the doc back in the states but now that the doc here is being so insistant, I'm thinking I need to go further into this whole thing!
I do always carry an epi-pen, but what is xyzal? I've not heard of that. I was told to give him Zyrtec if needed.
xyzal is zyrtec on steriods. (It is not a steroid) It is an antihistamine that is refined form of zyrtec. I keep it with my kids at all times and has stopped many reactions before they even really get going. So I have never had to give them an epi pen. It is one of those meds that is not covered at all through insurance and is expensive so most docs won't prescribe it. But my thought is that it is cheap compared to the alternative. It is safe to give to young kids I have my 3 year old on it so she can get her allergy shots. The other thing that I tell many in my family with environmental allergies is that a allergy doc is not an allergy doc is not an allergy doc. I went to 3 allergy docs before I found one that was helpful. As for the milk and eggs with the hearing that may be true. I have done a lot of internet searches and pasteurized milk allergies take many forms for my daughter it shows it ugly head in the form of eczema. Not that I can recommend this but she does fine with unpasteurized milk. So maybe doing a trial of no milk and eggs might be something just so you can rule it out. When my daughter had the ear infection that lead us to find out that she was allergic to PCN my allergist put her on zyrtec and zantac. These are h1 and h2 blockers instead of another antibiotic it worked. If you talk with your doc and s/he agrees to trial of H1H2 blockers along with no milk/eggs then you would have a better idea if the ear issue was allergy related. hope this helps
My three year old son has a severe PA, but he also has enviornmental allergies to dust, wool, and in general chemicals that seem to create the most day to day issues (head to toe eczema as well). He also has ear problems as result of the constant infections so we went with T-tubes when he was 8 months old. He has a ton of drainage but his hearing was saved. We also take xyzal, singular and bag full of other drugs, creams and lotions to address the eczema. We have seen a great improvement in the ear problems and skin issues since he was put on the daily breathing treatments in conjunction with the xyzal and singular. I too sing the praises of xyzal.
We were told that the asthma, eczema and allergies all run toghether so we do conference calls with the ear dr, dermatologist and allergist. Getting them all on the same page, really seemed to help. We do alot of trial and error as well, with things that may cause flare ups and breakouts. We keep a notebook of foods he has issues with and chemicals, soaps and other enviornmentals that seem to cause issues. Document as much as you can and keep your Dr.s up to date. Good luck!
Okay, I've read all of your responses above and have some real concerns.
How was it determined that your son originally had anaphylaxis? It is possible it is unrelated to the ball in chest issue--but was this a self diagnosis? Had he been eating prior? Was he possibly stung by an insect like a bee? I'm trying to understand that relationship to what happened and the anaphylaxis dignosis.
Next--In my opinion--you definitely need to see another medical professional. Any Dr. that tries to push a treatment on you has another motive. SLIT is still in many study phases and the fact that the person you are seeing is 1. pushing this treatment on you and 2. is ignoring the symptoms/history of symptoms says something is up to me.
I find it hard to believe that they can do SLIT but not a food challenge.
Lastly Zyrtec is a slow working antihistamine that is used typically for seasonal allergies. You would want Benadryl for a quick acting antihistamine. However, I am not an advocate of using an antihistamine in place of the Epi-Pen--so be careful there. I just wrote an article about this featured on the front page.
It sounds like you are on the right track and will try to get another opinion. In the meantime--hang in there. I know this must be difficult and frustrating. Know that you at least have online support here. I hope it all gets better for you soon.
Any other questions--feel free to ask!
Ruth
Thanks Ruth,
With the first experience of anaphalaxis I believe was purely coincidence that he was hit with a baseball, I just wasn't sure if that kind of an adreneline rush could trigger his histimines to go crazy. He hadn't had anything to eat prior to the episode, but we were outside playing in the grass. There was no evidence to suggest a bug/bee bite of any sort. We did initially think that could be the cause because there are a lot of fire ants in South Carolina. However, the allergy testing prooved negative to bug related allergies. In addition, there was no evidence on his skin of any sort of a bite. It was widespread all over his body, from the bottom of his feet to his head, and the swelling was also all over his body. His breathing was the scariest part of it all! We immediately brought him to the ER where they gave epinepherine straight into his stomach x2.
After that hospitalization we ran his first series of allergy testing, both skin and blood. His highest allergen was grasses which is what we belive caused the episode. But again, it hadn't happened before or since. He's always ALWAYS outside. As I mentioned before, his food allergies on the test were in the low-normal levels and did not cause any concern with that particular allergist. It was not even an issue for him to discuss with us, which is why I was so surprised when this dr here wanted to run another battery of tests for his ear issues. When it came back I was even more surprised when he got so worked up about his food results.
As for the SLIT therapy, I'm in total agreeance with you. I don't like the way it was pushed on me and when I questioned the "why" I was met with complete annimosity. The doc's whole demeanor changed when I brought up all my questions. He told me he wouldn't even consider doing the SLIT therapy to address his peanut allergy. This doc is heading up the trial here, and I do believe that is what is driving his desire to have my boy on it. Kind of a double standard if you ask me.
I will continue to persue a second "stateside" opinion and hope that they will get it done.
Thanks to all of you for all the info. I'd like to think I'm pretty smart with all my questions and concerns, but this whole allergy world is new to me so I very much appreciate all the input.