failed food challenge today

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Joseph had his food challenge this morning. Last month he had a neg. rast, and spt. He was finally at a point where he wanted to do it and was such a good boy. He tolerated a bit on a q tip, then a bit more on a q tip. Then, 1/4 tspn on a cracker and he got an itchy, red, swollen eye, blotches around the mouth, and blotches on his back and stomach. He got a runny nose and became drowsy. That was the end of that. He got better with benedryl. Allergist says to try again in a year. I'm so disappointed!!! Trying not to cry so ds doesn't get upset. Just so disappointed.

Julie

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On Jul 26, 2005

(((hugs))) Sending a angel your way.

------------------ Love this site Synthia

On Jul 26, 2005

More hugs and prayers being sent your way. Soo sorry. Keep that chin up, you still have hope....

Have a blessed day, Bridget

On Jul 26, 2005

I am so sorry Julie.

On Jul 26, 2005

Thanks so much for your warm thoughts. Just finally got ds in bed. He's awfully drowsy from the reaction and benedryl. I'm disappointed, but atleast I know the drill. We just keep on the way we've been. I really thought it would have turned out differently. I think the worst part beside watching Joseph have a reaction that I essentially caused, was his sisters' reactions. 6 yr old dd is so mad at God. 8 yr old is is just worried way beyond her years about ds starting preschool next month. I couldn't do this whole peanut allergy thing w/out all of you! Just trying to stay positive and faithful. JUlie

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On Jul 26, 2005

So sorry Julie [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] I know what it feels like to fail a challenge with preschool breathing down your neck. Of course, ours was to milk, so it's not the same thing.

Big hugs to you and your kids. I'm sure you just feel so disappointed and wiped out. Try to do something nice for yourself in the next few days [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Meg

------------------ ***[b] ALLERGY ELIMINATOR*** [/b]

Meg, mom to: Matt 3 yrs. PA,MA,EA Sean 3 yrs. NKA

On Jul 26, 2005

I'm so sorry! [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] It makes me so angry when I hear about negative tests and a positive challenge! I just don't get it! I pray some day both of my sons get a negative test back from any of their allergies, but I obviously can't trust what the results say until a challenge is done.

Does anyone know the % of failed challenges with negative RAST & SPT?

Again, I'm sooooo sorry for your results! [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] Ree

------------------ Mom to: Sean (9/01) - PA & EA Brian (10/03) - MA, PA, EA, dog Expecting #3 (3/06)

On Jul 27, 2005

SPT isn't always reliable because serum can be old, improperly stored, or not "complete*. Additionally, it's not reliable because some folks aren't contact reactive and others react to *any* scratch. It's useful used in conjunction with RAST, CAPRAST, and observation.

And it makes sense for a RAST to be negative if someone is super vigilant about avoidance. Most folks have immune systems that won't produce specific IgE antibodies if the offending substance isn't consumed.

All of this is why a doctor worth zir salt will insist on a supervised challenge if the tests come up negative. It's much safer than just assuming one is no longer allergic.

ygg

On Jul 27, 2005

There are very strict guidlelines on how antigen for skin prick tests should be stored, so that it is not "incomplete". And there is no "serum" in the antigen they use for a skin test. Also, they use a positive control and a negative control which rules out the situation where a person isn`t "contact reactive" or "reacts to any scratch". These are all very scientific tests done under very strict guidelines.

It is extremely rare for a RAST to be negative simply because we as parents are super vigilant about avoidance. Most of us on these boards can attest to that. That is the reason that a negative cap rast is such an optimistic sign.

Ree, about the percentage who have a negative rast and fail a challenge, different doctors use different rast cutoff for a challenge. I read an article written by Dr. Wood in which he said he will do a challenge if the cap rast is low enough that there is a 50% chance the person will pass the challenge---in other words, 50% will fail the challenge. Our allergist uses a much lower cutoff. He won`t due a challenge unless he is at least 99% sure the person will pass. I really think some allergists are more conservative than others.

Julieneaman, I`m sorry to hear about what happened. One good thing that came out of it is that at least a small amount doesn`t appear to trigger a severe anaphylactic reaction. So maybe although he failed the challenge, maybe you won`t have to worry so much about inadvertent trace exposure causing a severe reaction.

On Jul 27, 2005

Quote:

Originally posted by Carefulmom: [b]Ree, about the percentage who have a negative rast and fail a challenge, different doctors use different rast cutoff for a challenge. [/b]

So, do think doctors tell the patients they have a negative RAST, but maybe it's more like .36kU/L? It just seems like so many people have posted lately that they've received a negative RAST but had a food challenge reaction. When they say 'negative', is it truly zero or just a really low Class 1...KWIM?

On Jul 28, 2005

I always ask for a copy of the cap rast (or rast). That`s just me. It is easier to remember all the details if I have a copy. Plus it is easier for me to see it, come up with my questions, then call the doctor to talk about the results. The other reason I like to have a copy is it is very helpful to show to the school, when they see how high above the cutoff her level is---then they see that I am not making up just how allergic she is. I think it is easier to get what you are asking for on a 504 with a lab slip in your hand.

Anyhow, for a cap rast, the cutoff for normal depends on age. The reason I know this is that when she was 9, the cutoff was 0.10 and when she was retested the tech forgot to enter her age, so they put the cutoff for an adult which is 0.35. If it is below the cutoff, the lab slip will just say less than 0.10 or less than 0.35 or whatever. If it is positive, it has a number like 1.02 or 3.95, etc. I know when dd`s egg cap rast was 0.11 with the cutoff being 0.10 he called it negative, did a challenge and she passed. I know that in Dr. Wood`s article the cutoff he uses for an egg challenge was way higher than this.

On Jul 28, 2005

Careful Mom,

Thank you so much for your post. It was very informative. I am going to ask for copies of his actual scores. I appreciate your kind thoughts, too. I'm still feeling guilty about going ahead with the challenge. I know some here think 3 is just too young regardless of scores. Maybe they were right. DS doesn't seem to make the connection b/w the cause and effect of what happened. I'm just having such a hard time getting over the disappointment. I don't know why. He isn't any worse off than we were a few days ago. Oh well. Do you think this exposure could make him "more allergic?" Thanks! Julie

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On Jul 28, 2005

My allergists have all acknowleged that the liquids used in skin prick testing can be old, even when properly stored, and that the allergens being tested might not survive the process or storage. They hope that the stuff is reliable, but they all agree that it is not 100%.

ygg

On Jul 28, 2005

Wow, it sounds like your allergist`s office does not read the instructions that come with the antigen, telling them how to store it.

Julie, I don`t think you did anything wrong. If I had been told my child`s cap rast was negative, I would have done a challenge also. I wonder what the actual number was. If you don`t mind, and if you could find out, it would be helpful to know for other people considering a challenge.

I`m the one who had the Van De Kamps incident (product was mislabeled, contained milk but milk was left off the ingredient list, dd is milk allergic and I gave it for 9 months until she had a reaction). Anyhow, even though the incident made me livid and still does, the one good thing that came out of it was that since she ate a product with milk for 9 months and did not react, now at least we don`t worry so much about someone eating Cheetos and touching her. So maybe you could look at it the same way. It sounds like you would not have to worry so much about trace exposures the way so many of us on this board do worry about it with peanuts.

[This message has been edited by Carefulmom (edited July 28, 2005).]

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