Boston Globe - Peanut Allergy Epidemic May Be Overstated

Posted on: Mon, 01/30/2006 - 2:31am
Heather3's picture
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[url="http://www.boston.com/news/globe/health_science/articles/2006/01/30/pean..."]http://www.boston.com/news/globe/health_..._be_overstated/[/url]

Can someone explain this statement to me "And while extremely high levels often do mean real allergy, the converse is untrue; most children with real allergies don't have very high IgE levels."

Does that make sense to anyone?

Posted on: Mon, 01/30/2006 - 2:49am
Going Nuts's picture
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And what about this one:
"This test isn't very precise, though. According to a 2001 study from Clinical and Experimental Allergy, only 40 percent of children with even strongly positive skin tests (a hive more than 5 millimeters wide) had positive food challenges -- and of them, only half had reactions needing any treatment."
Why would anyone with a strongly positive skin test even be having a food challenge? Did they have a positive skin but negative RAST? Huh?
Amy

Posted on: Mon, 01/30/2006 - 3:09am
tando's picture
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I'm very disappointed in this article.
1. The author is a pediatrician, not an allergist, this should have been disclosed in the first paragraph.
2. The author provides details as to the weaknesses of the studies he criticizes but no similar details of the studies he cites. Case in point, 40 percent of how many children had positive reactions in a food challenge? Under what circumstances were they given food challenges since according to our allergist, food challenges are not given to children with positive skin tests?
3. The quote from FAAN is misleading and powerfully so. I believe FAAN's intent here was 25 percent of all parents, not parents of children with medically diagnosed allergies. Presumably, parents with medically diagnosed allergies are all in the 4 percent.
I could go on, but I won't except to say I'm very disappointed in the Boston Globe for printing this poorly documented, inflammatory article disguised as a well documented, authoritative piece.
T.
[This message has been edited by tando (edited January 30, 2006).]
[This message has been edited by tando (edited January 30, 2006).]
[This message has been edited by tando (edited January 30, 2006).]

Posted on: Mon, 01/30/2006 - 3:59am
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ditto ditto...
bad article IMO as well.
Caitlin's allergic to multiple things... AND has a high total IgE.
Jason
------------------
[b]* Obsessed * [/b]

Posted on: Mon, 01/30/2006 - 4:08am
qdebbie1's picture
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How do these people get jobs writing for a newspaper. Did they do any research.
Lets ask this guy, he is a "doctor"
Dr. Darshak Sanghavi, an assistant professor of pediatrics at UMass Medical School, can be reached at [url="http://www.darshaksanghavi.com."]www.darshaksanghavi.com.[/url]
Looks like its time for everyone's favorite segment.
Letters to the Editor.
[url="http://www.boston.com/help/feedback/"]http://www.boston.com/help/feedback/[/url]

Posted on: Mon, 01/30/2006 - 5:09am
Gail W's picture
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This is the paragraph that bugs me the most:
[i]While food (and, particularly, peanut) allergies make headlines -- like the Canadian teen who died last November after kissing her boyfriend who'd eaten a peanut butter sandwich -- the Archives of Internal Medicine in 2004 reported that the average person's chance of food-induced anaphylaxis is about 4 in 100,000 per year. Roughly the same number of Americans each year die from lightning strikes as from peanut allergies.[/i]
The "average person" isn't allergic to food, so of course their chances of having an anaphylactic reaction from food is extremely low. [i]Geesh! [/i] What an idiot!

Posted on: Mon, 01/30/2006 - 5:13am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

I am probably in the minority here, but I don't think he's so terribly off-base.
I mean, there are many, many "PA" kids who were diagnosed with a single RAST or SPT whose parents take no particular care to avoid traces and yet these kids have NO reactions. EVER. Are they really "allergic?" I don't know. But I suspect that though their parents would say "yes," in a telephone survey, this is the group of kids most likely to "outgrow" and that they may never have had a clinical sensitivity at all. These are the people that we here find at the root of some of our very thorniest issues-- like schools and airlines which don't feel the need to accomodate anyone because very tiny traces "shouldn't" pose a problem for most PAs. They haven't for the PA people they've met. (See what I mean?)
Anyway, he DOES have his facts straight. The only way to accurately diagnose any food allergy is with a challenge. It is misleading of him to say that this carries a "small" risk of injury to those with a real allergy, however. He's also correct (though you ain't supposed to use no double negatives, in my recollection [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img] ) in saying that high IgE nearly always means allergic BUT that low IgE doesn't always mean "not allergic." He just said it in a bizarre manner.
And as far as prevention efforts go, he's absolutely correct. The only studies out there show either no effect at all, or a questionably meaningful one due to small sample sizes. Obviously you need to avoid pn if your breastfeeding infat ALREADY shows signs of sensitization... but does protein in breastmilk CAUSE sensitization? Nobody knows. It could PREVENT it, at the right dose and timing.
What I think he should have mentioned and didn't is that while many people out there may be embracing the PA label without cause, for those who really ARE allergic, this is no joke, and that crazy careful is not always careful enough. He DID mention Christina Desforges, so he isn't denying the reality.
I know people who consider their child "allergic" though they have been entirely reaction free (including known exposures to contaminated foods) for years and years and have NEVER had a severe reaction. They privately admit to me that they really have no idea if the child is "still allergic" but don't plan to change anything. The difference is that they can afford slip-ups and the rest of us can't. When others see them, they assume I am the crazy one.
So I see his point. Parents who ask for accomodations their children DON'T really need make it harder for those of us who really do need them. And that cuts accross all types of allergies.
Edited to add that I agree with Gail's complaint about the one paragraph-- he is a bit unclear when he's referring to the population as a whole versus those with medical diagnoses. And I don't think he's referring to "total IgE" when he says IgE, by the way. I think he means allergen specific. I really don't interpret his article in the negative light you all did. I thought he was surprisingly WELL-informed given that he isn't an allergist. (I've seen worse. A LOT worse...)
[This message has been edited by Corvallis Mom (edited January 30, 2006).]

Posted on: Mon, 01/30/2006 - 5:26am
anonymous's picture
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Joined: 05/28/2009 - 16:42

Debbie, he probably does not actually have a job writing for the paper. Newspapers do print articles written by people who do not work for them, but simply write just one article, or an occasional one. He probably wrote it because he was annoyed by the no-peanut policy he cites at the beginning of the article, and the paper thought that as a doctor, he is expert enough to know what he is writing about.

Posted on: Tue, 01/31/2006 - 1:37am
tando's picture
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Corvallis Mom,
I agree with you that the writer appears to know a great deal about allergies -- to me that's the problem. I'm disappointed with what I see as his failure to accurately inform. I find the piece very inflammatory because so much data is thrown in but not IMO presented well enough to truly educate. IMO, more distinction should have been made between the population as a whole (non allergic, thinking they are allergic but suggested here that they may not be, and truly allergic).
I agree there could have been a great, informative, educational article here. I just don't think the one printed did what it could have done and I'm disappointed that two voices of authority (the writer and the paper that published the article), didn't do what they might have done.
T.

Posted on: Tue, 01/31/2006 - 1:47am
MommaBear's picture
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Corvallis mom, thank you for what *I* believe to be a very insightful and [i]unbiased[/i] opinion. Did I mention non-emotional? Ok, "non-emotional" too. edit to add: hey, I could be wrong. It doesn't matter what I believe. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
Thank You. Again.
[This message has been edited by MommaBear (edited January 31, 2006).]

Posted on: Tue, 01/31/2006 - 9:00am
notnutty's picture
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Joined: 03/15/2004 - 09:00

"The only way to accurately diagnose any food allergy is with a challenge."
Funny...I was told that my son's IgE levels to peanuts were so high that a challenge could be deadly. We didn't even do a skin test because of the dangers involved. My DS is a Class VI to peanuts.
Perhaps the two anaphylaxis episodes we have had are challenge enough...but was not in a clinical setting. Yet I firmly believe his diagnosis is accurate and I will continue to treat it as such.
IMO food challenge for peanuts is dangerous...and is not necessary for an accurate diagnosis.
Donna

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