Dd passed egg challenge but seems to be having symptoms---don`t know what is going on

Posted on: Sun, 06/27/2004 - 1:44am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

Dd has a history of anaphylaxis to egg at age 2 years 8 months. She had never had egg until then. She was skin tested and was negative. A few days later I gave her scrambled egg. She ate two bites and then sneezed about 50 or 100 times, developed hives and swelling around her eyes, and wheezing. I used the Epi. A month later she was skin tested again and was very positive for egg. Her allergist said the first skin test must have sensitized her. As you can imagine, being told she is not allergic, giving her egg, and then having to save my child`s life was somewhat traumatic.

Now she is 9. She was rast tested in May and was negative for egg. She was food challenged last Wednesday. She had hard boiled egg white, then some egg salad (hard boiled egg chopped up with mayonaise which has egg as an ingredient), then some scrambled egg. I noticed after the scrambled egg she cleard her throat a few times and was a little (very little bit) hoarse. The nurse got the doctor but in the 30 seconds it took him to get there, the hoarseness was gone---it lasted that short of a time period. He said maybe she is getting a viral illness. At some point he mentioned that due to the fact that she has been off egg for so long, it may take awhile to build up the enzymes that digest egg, so to go up slowly or she may get diarrhea. He told me to give her one egg Thursday, two eggs Friday, then she could have as much as she wanted. Since then I have noticed when I give her egg at home, she does get a little hoarse for about a minute and clears her throat a few times. The whole thing lasts maybe 3 to 5 minutes. Yesterday she had two eggs made into egg salad. Afterwards she coughed once (had not been coughing at all before then), then cleared her throat a few times. She never has any rash or wheezing like when she had egg at age 2 and I used the Epi. She has also had cinnamon rolls since Friday which have egg as an ingredient and has had no problem.

Anyone have any idea what is going on? Is this just because she does not have enzymes to digest the egg? Or is this a mild allergic reaction? I thought that with the rast test negative she could not be allergic to it. I have asked myself is this my imagination because it was so horrible at age 2 to think she is not allergic to egg because of negative skin test, then give her egg, and have to save her life. But she really is clearing her throat and hoarse, and I am not imagining it. Is it possible that she is sensitized again in the last few days? I am wondering if I should ask for another rast test and see if it is now elevated. What does everyone think?

[This message has been edited by Carefulmom (edited June 27, 2004).]

Posted on: Sun, 06/27/2004 - 3:26am
AlwaysAvoidAnaphylaxis's picture
Joined: 06/23/2001 - 09:00

Tough question. We are all super sensitive to any changes in our child and have a high index of suspicion as we should. The hoarseness and cough seems to happen after eating egg but not after eating other safe foods. So it is coming from the egg. Do you think your daughter is clearing her throat because she is worried? Have you asked her if her throat hurts or is itchy after eating the egg? We all know an allergic reaction wouldn't likely be so short and minimal---could it? What would I do? Maybe repeating the CAP RAST to make sure it is negative a second time is the way to go. Should you not give her anymore egg? I might continue to do it but may just do it once per day and watch her closely. Hope that helps.

Posted on: Sun, 06/27/2004 - 4:38am
Westporter's picture
Joined: 06/25/2003 - 09:00

Not sure if this helps but, I have some food allergies (not anaphylaxis) but were much worse as a child. Now as an adult, after eating certain foods, (i.e. milk, egg, cheese) I immediately get post nasal drip which causes me to unconsciously clear my throat a lot. I never put two-and-two together until I recently saw an allergist and happened to be clearing my throat at the time! He asked me what I had for breakfast, and viola, food allergy reaction - post nasal drip!!!
So, hopefully your child can handle food like me, but just has the slightly annoying post nasal drip. Ask her if that's what's happening the next time she's clearing her throat. Good luck!

Posted on: Tue, 06/29/2004 - 5:17am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

Well, the post nasal drip is a possiblity. I wonder if that is a mild form of an allergic reaction. And also if it has the potential to turn into anaphylaxis in someone who has already had anaphylaxis due to that food. I think I`ll continue to give her egg, and if the throat clearing/hoarseness continues ask him to repeat the Cap Rast.

Posted on: Tue, 06/29/2004 - 6:16am
jtolpin's picture
Joined: 05/28/2003 - 09:00

Let me think this thru, now...
If you re-do the RAST, and it comes back -, then what? You'd believe shes not allergic, and continue egg challenge, right?
If it comes back +, would you stop the challenge immediately?
So the results of the test WOULD impact the oral challenge... But what if EITHER of them are false (+ or -). Then what? You're challenging a food that shes allergic to, OR you DON'T challenge a food shes NOT allergic to...
My first inclination, was that she KNOWS shes eating eggs, and worried about it. Tough to hide egg in a food that she hasnt had before, and she KNOWS its egg (see: egg salad sandwich)
And its tough to determine how MUCH egg is in, say, a jelly doughnut... a food she doesnt normally eat as well...
Tough to say what'd I do, since I'm not IN that situation now... and my ideas MAY change at that point...
And to make it even a tougher call, her history of eggs...
None of this helps you whatsoever, so I apologize for that.. I'm not just rehashing, but reading as I type, in hopes of giving you any advice... But it doesnt seem like I have any.
Ask her, perhaps? Does she want to continue with egg challenge, or does she want to continue avoiding eggs? She's 9? Is that old enough to make such a decision?
I dunno... I know, whichever way you choose, will be the right one.
Good luck!

Posted on: Tue, 06/29/2004 - 6:30am
momma2boys's picture
Joined: 03/14/2003 - 09:00

One other thing to keep in mind, my ds is very allergic to eggs, but can eat them in baked goods, etc. with no problem.
My pa ds basically tested negative recently to eggs both rast and skin. So we tried at home (I know, but this was during idiot allergist time period) on his advice and after the first bite he gagged and threw up. So is he allergic or doesnt like them? We decided better safe than sorry and still avoid them.
Have you asked the allergist what he thinks?

Posted on: Wed, 06/30/2004 - 12:25am
becca's picture
Joined: 05/22/2001 - 09:00

I would discuss it with the allergist, and maybe they can re-do some blood or skin testes in a few months to see if there is any return of antibodies.
My dd ate PB for a couple of months, regularly before having allergy to it. It was not anaphylactic at the time either.
I would certainly keep the epi around and handy if you choose to cont feeding eggs. It is a mild reaction. becca

Posted on: Wed, 07/07/2004 - 8:51am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

Well, I`m finally back to this thread. I typed a long response a few days ago, but was having computer problems and my response did not go through. Jtolpin, I did not have the impression that she was worried about the egg challenge----in fact she was really excited about it---more excited about the egg challenge than about her birthday party! (and she was pretty excited about her birthday party). I suppose she could have been worried subconsciously, but I don`t think she was worried consciously. And yes that is what I would do---repeat the Rast and if it is negative it would reassure me. If it is positive, I would stop egg immediately. As it turned out, it has now been two weeks since the egg challenge, and dd has decided that she does not like egg all that much. She does not like scrambled egg or fried egg. She does like egg salad. Because I work full time, there has not been much opportunity to give her egg salad. During the week, I would not be comfortable giving her egg for breakfast, and then taking her to day camp right away and leaving. And for dinner, well, egg salad is not much of a dinner. She is eating French toast with no problem. She has had it three or four times with no symptoms. It has one egg in it, and I figure from the standpoint of the egg, it is pretty much like a fried egg, right? She had half an egg salad sandwich last week and cleared her throat one time only. So it is a little hard to make much out of that. I wish I could get her to eat 2 scrambled eggs so I could see if she has symptoms, but now that she does not like them, if she ate them and threw up I would not know if she is allergic or just doesn`t like them. She has been eating cinnamon rolls made with eggs and has no symptoms. But then there are people on these boards who have kids who are allergic to egg, but are able to eat it baked in something. Momma2boys, I have not asked the allergist yet. I figured I would wait and see if she continued with hoarseness and throat clearing or if it stopped. Then once she decided she does not like scrambled or fried egg, it is hard to say. She is seeing the allergist tomorrow for a sweet potato food challenge. Maybe I will give her egg salad tonight---no bread, just egg salad so she gets a lot of egg and see what happens. Then if she has symptoms, I can bring it up when we see him tomorrow. Becca, I will definitely keep the epi around, in fact I don`t think I would feel comfortable sending her to school with egg until she has had it at least for 6 months with no problem (at least 100 times). Once you have treated your child for anaphylaxis to egg, it is hard to let go of that. I know if anything horrible happened I would use the epi, but you never really know how the school will handle an emergency until the emergency happens.

Posted on: Wed, 07/07/2004 - 11:14am
California Mom's picture
Joined: 07/14/2000 - 09:00

Good luck, Carefulmom. At least it should help a lot if your dd can safely eat things with eggs baked into them. I hope the sweet potato challenge goes well!
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Miriam

Posted on: Thu, 07/08/2004 - 4:29am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

Well, the mystery about the hoarseness and thraat clearing after egg may be solved. She had her sweet potato challenge today. She ate a small amount waiting 20 minutes, ate more and waited an hour. About 50 minutes after the second one she said she felt hoarse. She did not sound hoarse at all. She did not have any other symptoms. Plus 50 minutes after eating it is a long time. The allergist was standing there. He thought she sounded fine. He listened to her lungs and everything was fine. He said it might be reflux. She had severe refux from birth until age 2, and she often got hoarse with reflux. She also used to choke with reflux. She was on adult doses of reflux meds by age 2. She almost had surgery for it, then she outgrew it. It still flares up occasionally. So I am thinking that maybe that was why she got hoarse and throat clearing after egg, yet had a negative Cap rast. So I just thought I would share that. I am less worried about the egg now. I plan to continue it as much as she wants it. If the sypmptoms seem pretty striking, I`ll ask for another Cap rast. Cranberry challenge is next---just have to figure out where to find them this time of year. He says they should be fresh cranberries.

Posted on: Thu, 07/08/2004 - 9:59am
California Mom's picture
Joined: 07/14/2000 - 09:00

Great news about the egg and sweet potatoes!!! Good luck with the cranberries, too. I wonder why they have to be "fresh"? Do you think frozen or canned would do if you can't find fresh?
Take care, Miriam



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