Blood test scores

Posted on: Thu, 10/02/2008 - 8:58am
brettsmom's picture
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Joined: 10/02/2008 - 15:51

Hello! This is my first time posting here although I have been reading your posts for quite a while. My son is 2.5 and had a pretty severe reaction to peanut butter when he was just over a year old (vomiting, coughing, red eyes and swollen lip) that was cleared up with Benadryl by the time we saw a dr. at the ER. No reactions since then, but we have strictly avoided. He just had his first blood test on Monday and the dr. called today to tell me that his test number was 5.59. He said this was elevated but relatively low and we could be hopeful that it might go down next year. Can anyone give me any background on the scale for this test, what numbers are high, low, etc? I just want to know if anyone has an opinion on his chances of outgrowing his allergy or is this even enough information? Thanks for any input!

Posted on: Thu, 10/02/2008 - 10:09am
lakeswimr's picture
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Joined: 02/01/2007 - 09:00

I'm sorry your child has food allergies. Have you seen an allergist? Do you have epi pens and an emergency plan? If not please print the one off at [url="http://www.foodallergy.org"]http://www.foodallergy.org[/url]
Here is the link to their sample emergency plan.
[url="http://www.foodallergy.org/actionplan.pdf"]http://www.foodallergy.org/actionplan.pdf[/url]
Most food allergy reactions will self resolve but some will be fatal if left untreated. Benadryl won't stop a reaction from progressing to life-threatening. Only epi pens can do that. Past reactions and test scores unfortunately do NOT tell us who will or will not have a life-threatening reaction. Your child had a systemic reaction in the past and that means your child could have a life-threatening reaction upon next exposure. The average person with a peanut allergy has a reaction due to accidental ingestion ever few years. So, if you do not yet have epi pens please call your doctor tomorrow at get a prescription for 2. they should be with your child at all times along with a person who knows the signs of anaphylaxis and how to use the epi pens and your child's emergency plan. If you already knew all this sorry. I was just assuming because your child wasn't tested until now.
As for the test score--5.59 along with the reaction you have seen = a positive score. Scores alone don't tell us how severe a reaction might be unfortunately. If you have a known food allergy for sure then there are scores above which are called a positive predictive value to have anaphylaxis and below which are called a neg predictive value. Your child's score is in between these two, I believe. I'm not sure of the PPV for peanut but the neg is I think about .9 and with scores *below* the neg predictive value I believe you only have a 50% chance to pass a food challenge for the allergen. If you are above the positive predictive value you have, I believe, a 95% chance of anaphylaxis, though.
I would say that it sounds your child is still allergic and that it is p ossible your child might outgrow this one day but might not. Only about 20% at most do outgrow peanut allergy. Duke university and others are making treatments and possible cures though.
I have seen a lot of kids who have scores closer to 100 for peanut so I'd say that's not a bad score. However, really, scores mean pretty much nothing. Your child has this allergy for now but with the treatments being developed the future is very bright. Hang in there!

Posted on: Thu, 10/02/2008 - 11:22am
brettsmom's picture
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Joined: 10/02/2008 - 15:51

Sorry I didn't do a great job of explaining my background. We had skin tests twice last year with positive results for peanut, this was our first blood test though. Our allergist performed all the tests and we do have the epi pen now although thankfully he didn't need one at the ER the first time as the benadryl was sufficient. Luckily no reactions since. Thanks for the information, I am hopeful that he will outgrow although I know the odds are against that - I guess I can just hope that his score goes down next year.

Posted on: Thu, 10/02/2008 - 12:00pm
lakeswimr's picture
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Joined: 02/01/2007 - 09:00

Originally Posted By: brettsmomSorry I didn't do a great job of explaining my background. We had skin tests twice last year with positive results for peanut, this was our first blood test though. Our allergist performed all the tests and we do have the epi pen now although thankfully he didn't need one at the ER the first time as the benadryl was sufficient. Luckily no reactions since. Thanks for the information, I am hopeful that he will outgrow although I know the odds are against that - I guess I can just hope that his score goes down next year.
Oh, that's good!
There are also positive predictive values for skin testing. Anything 8mm or larger has something like a 95% of ana reaction. Do you know the size of your child's skin test?
Best wishes!

Posted on: Thu, 10/02/2008 - 1:45pm
brettsmom's picture
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Joined: 10/02/2008 - 15:51

I can't remember the exact size, but it was above 10 on peanut (skin test), I'm thinking 11. However, he also tested positive for egg on the skin and it was even larger than the peanut (13?) and he had been eating egg products almost daily but never reacted. The first allergist we saw wanted egg removed from his diet, but our new dr. did not want anything removed that he had not reacted to. So, that is confusing to me as well on the skin test - hard to figure out what it all means - they didn't test his blood for egg, just peanut. He has been eating egg again for over a year with no reactions whatsoever. I know I just have to wait it out each year and there really aren't any answers, but it is hard not to try to figure it all out and find something to cling to and hope for!

Posted on: Thu, 10/02/2008 - 11:33pm
lakeswimr's picture
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Joined: 02/01/2007 - 09:00

That is a good sized skin test result. Doesn't mean it won't change, though. For now you know there is the peanut allergy. As for the other foods the 2nd doc is right. Testing is only 50% accurate for positive results but over 90% for neg. That means that it isn't a reliable method on its own to determine if the food is a true allergy or not and FAAN, etc do not recommend we remove food from our diets *just* based on test results, esp if the person has been eating the food just fine. For *know* allergies (like peanuts in your child's case) the tests can confirm and give info such as positive predictive values and help see if one is outgrowing or not.
Best wishes!
Originally Posted By: brettsmomI can't remember the exact size, but it was above 10 on peanut (skin test), I'm thinking 11. However, he also tested positive for egg on the skin and it was even larger than the peanut (13?) and he had been eating egg products almost daily but never reacted. The first allergist we saw wanted egg removed from his diet, but our new dr. did not want anything removed that he had not reacted to. So, that is confusing to me as well on the skin test - hard to figure out what it all means - they didn't test his blood for egg, just peanut. He has been eating egg again for over a year with no reactions whatsoever. I know I just have to wait it out each year and there really aren't any answers, but it is hard not to try to figure it all out and find something to cling to and hope for!

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