A couple of questions...

Posted on: Wed, 03/26/2003 - 5:47am
Gwen 5's picture
Joined: 01/24/2003 - 09:00

Hi, I have a few questions so here goes:

1. If your child has PA/Nut allergies should they only have the blood test when retesting or is a skin test ok too?? My daughter had skin testing and she reacted with raised welts at the site, the allergist gave her Zyrtec after the reaction.

2. At what poiont do you switch from Epi Jr to regular epi? Is it based on weight? What is the range. Also how many Epi pens do you get a prescription for?

3. Have any of your children tested positive for nut allergies but have never had a reaction?

My dd was skin tested for food allergies when she was diagnosed with mild asthma. She tested positive for many things but I told them that she has eaten these things for along time. She was food challenged for all, except nuts and passed it all. They don't want her to eat nuts- which I understand but it does worry me since she has never eaten them anyway.

Any insight would be helpful. Thanks

Posted on: Wed, 03/26/2003 - 7:14am
Corvallis Mom's picture
Joined: 05/22/2001 - 09:00

First, Gwen, keep in mind that this is all just my opinion- different allergists have different philosophies. The key is to find one whose philosophy you can personally live with and understand so that you can work with him/her.
With a positive skin test, there probably isn't any reason to do a RAST unless you have some reason to think that your child isn't really allergic. If your child has additional reactions with exposure to pn, for example (not that you would do so intentionally, mind you- but it does happen accidentally) you don't need to test to know that they are allergic. If your child has a few anaphylaxis incidents, especially if you suspect that this is to minute traces or to a cause that you aren't even sure of (in other words, vanishingly small amounts), then you should at least bring up the idea of NOT skin testing at all. We will not allow our daughter to be skin tested- our allergist feels the risk is small, but I do not.
Neither mode of testing is perfect- both are pretty good (80-95%)at predicting the absense of an allergy to something, but you can have a positive skin test/IgE measurement to an allergen without ever reacting to it in reality. So false positives abound when it comes to the "moderate/mild" type of allergies.
(This is based on our own observations and discussions with our four allergists- common sense is worth a lot more than tests.)
Good luck figuring out what your tests mean for your child. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
Oops- I forgot (editing) With the epipen versus junior epi, I think that Dey has some pretty specific guidelines, which your doctor or pharmacist should be able to access. One caution (based on experience) is to make certain that your health professional doesn't assume that 1 pound= 1 kg!! (It's actually 1 lb= .45 kg, if you need to convert it yourself) [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
[This message has been edited by Corvallis Mom (edited March 26, 2003).]

Posted on: Wed, 03/26/2003 - 9:18am
SpudBerry's picture
Joined: 07/23/2002 - 09:00

The only question I have an answer for is just my opinion - not medically backed up.
I will never allow my son to be skin tested. He has only had one reaction - 2 years ago, and it was a doozie - full blown ambulance ride with screaming paramedics and the like.
So now that we turned 3 lately & I showed up at the local allergist to see just how bad things were, he wanted to do skin testing - I thought not! I informed him that I had been trying to avoid peanut like the plague for the past 2 years I wasn't going to purposefully expose him to it now just because the doctor wanted to see how he'd react.
So we did the RAST blood test. Afterwards, the doctor came back with the results (REALLY HIGH) he humbly said - don't ever have him skin tested it's too much of an un-needed risk. I didn't respond.
Oh - and I currently have 5 Epi-Jr's around - but I'm thinking of getting a few more next time because I'm thinking of carrying 2 around instead of just one. In case of an accident, dud, or severe reaction needing more than one injection.
Hope that helps!
Mom to 3 year old twins Ben & Mike - one PA & the other not.
Stay Informed And Peanut Free!

Posted on: Thu, 03/27/2003 - 4:09am
Shawn's picture
Joined: 09/07/1999 - 09:00

Regarding the Epi-pen: yes, it's based on weight. Standard adult dose is .3 mg, the amount injected by a regular EpiPen. The EpiPen Jr. gives half that dose and is generally used for children under 30 kg (approx. 65 lbs). However,the dose may be raised earlier, in the allergist's discretion, if he/she feels it necessary to use more or less Epinephrine.

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