Anaphylaxis Vrs. Testing...

Posted on: Tue, 11/02/1999 - 5:47am
LouiseLarsen's picture
Offline
Joined: 06/07/1999 - 09:00

I have some real questions about my child's Allergies.

However, to present the questions in their proper perspective, I need to spell out much of her previous "history":

So, if there are any "Allergy Sleuths" out there with the time and/or incination for our situation, I sure could use your insight...

So; To begin:

My daughter, Juliet, had a severe anaphylactic response to one bite of peanut butter when she was 15 mos. old.

The reaction was very severe. The hospital said that they were surprised that she survived it.

We were refered to an Allergist who performed a "Blood RAST Allergy Test" for commonly "highly allergenic" foods.

The results were as follows:

(Mind you, I notice there is a wide variety of "types" of scoring.
Is there any one global way to compare all of these different results so that we can view our kids with the same measuring stick? - Question #1.)

The Allergist and/or the Lab used a chart breaking the IgE counts into 6 catagories:

THE IgE RESULT CATAGORIES:

0-750 = low equivocal
751 - 1600 = 1
1601 - 3600 = 2
3601 - 8000 = 3
8001 - 1800 = 4
1801 - 40000 = 5
4000+ = 6 ) --------

Juliet's first test results (done just following her anaphylaxis.) were as follows:

Peanut: IgE 31336, "Score": #5
Egg (whole): IgE 1776, "Score": #2
Walnut: IgE 1461, "Score": #1

(the rest of the results were considered too low to count.)

Okay:
So, fast forward another year (more or less.) and Juliet is now almost 3 and she appears to be getting resperatory allergies, too.

We live in Southern California and the autumn "Santa Ana Winds" have been considerable lately...Juliet developed a runny (clear & faucet-like.) nose, watery eyes, with her mucus left "allergic-like, bright pink streaks" where she accidently wiped her nose...(Bla, bla, bla...Classic hay-fever, maybe?)
...I take her back to be re-tested for allergies, with emphasis on "Enviromental ones".

So -
The Allergist schedules tests...
The nurse arrives with her test tray and proceeds to test Juliet for all the usual suspects.

Later, I was informed she no longer apperaed to have food allergies. And that her test to Peanuts had NO reaction.(?!)

(FYI - the only positive reaction was to Dust Mites (3+); nothing else.)

The Allergist said that he had never seen it before, but that maybe she'd be his first patient to "outgrow a peanut allergy".

At this point I strongly began to lobby for more tests as I didn't buy his theory that she was fine now.

He then agreed to do (only "some") more testing: His theory is she probably doesn't have serious allergies like we thought, and that she has no environmental allergies to worry about.
His comment was that "Everyone is bothered by the Santa Ana's, it doesn't mean she has an allergy."

So, (after I haggled a bit.) he ordered 6 shots on her arm:
Intradermal (shots) testing 6 "environmentals".
He also agreed to a blood test for Peanuts, Egg (whites) and Walnuts.

He said that even though the skin tests are usually the "golden rule" that these further tests "should explain everything".

Later that day (after the intradermals.) her arm only showed a "4 +" welt to Cats. But nothing else...at that time.
So, I left and took Juliet home.

-- HOWEVER:
The next day (On the weekend, of course.) she had large welt "reactions" to 3 other injection sites;

- The "Weed Mix", "Tree Mix" and "Grass Mix."

She also had a considerable raised rash all over her back which lasted for 3 days, even after giving her Benedryl.

Monday Morning:
I call the Allergist's office yesterday to run all of this by them.
The nurse relayed the
Allergist's message that "late reactions are not conclusive" and that "the blood tests will explain everything."
---------------------------------
So:

Does anyone else think this is all rather odd?
I was told the skin test was "the golden rule", what should I make of these different test scores?

For the record, I was confused and alarmed my daughter was re-exposed to peanuts after her previous anaphylaxis.

Has anyone else had their child re-tested for a food they were severely allergic to? If so, what happened?

Obviously this long-winded, but I need to ask these questions:

Does anyone have a child that outgrew a severe food allergy, (with known anaphylactic history.) within 1 - 2 years?

How reliable IS the skin test? What is the error rate on it? - Does it err to the "False neg." or "False Pos." side?

What about blood RAST tests? How reliable are they?

Has anyone out there had dramatically confliciting results to either the tests and/or the child's actual food history?

Got any advice regarding Allergists? Anything I should look for with one, or avoid in working with one?

Please let me know.

I also would like to add that the Allergist I see here (in Orange County, CA) is part of a well respected practice...But I am growing increasingly dubious about, frankly, any of them...Is anyone else as confused and jaded as I am?

I'm all ears.

And thank you for your (considerable.) time and energy in reading this.

Thanks! - Louise.
[img]http://client.ibboards.com/peanutallergy/redface.gif[/img]>

[email]loular@earthlink.net[/email].

------------------

I'm married w/ one child who'll be 3 yrs. on December 5, 1999.

I only learned about Peanut Allergy "the hard way", by giving her a bite of a peanut butter sandwich when she was 15 mos. old.

We almost lost her that day, and from then on have been stuggling to live a normal life in a world that is largely ignorant about Peanut Allergies.

I'd like to thank both PeanutAllergy.com and The Food Allergy Network for their tireless work in dealing with these issues.

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