Food challenge, talk to me please........

Posted on: Fri, 01/06/2006 - 2:45am
Tamie's picture
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Joined: 09/23/2002 - 09:00

My daughter who is 9 years old now got a new allergist and finally had a rast test done. She still tested positive to peanut, nuts, and other things that aren't food related. Her egg test came back low enough for the allergist to reccommend a food challenge. I was told to bring 3 scrambled eggs and a fork for her to the appointment. We go on the 12th of this month. Can anyone share their experiences of food challenges with me and what to expect? Thanks so much, I am a nervous wreck!
Tamie

Posted on: Fri, 01/06/2006 - 2:57am
gvmom's picture
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Joined: 08/24/2005 - 09:00

When you say her test came back low enough to do a food challenge using real live scrambled eggs, are you talking about a RAST? Did he do a skin test after getting the blood results? My younger son is allergic to eggs, and his last RAST came back negative. So we were guardedly optimistic, but he showed up positive still when a skin test was done to double check. I would guess there are other members, with way more experience than I, that could speak to this whole process. I, personally, would be nervous going straight from RAST to food challenge. I know though, that recently there have been members that have had food challenges lately, that could definitely add info here.......any of you around?

Posted on: Fri, 01/06/2006 - 3:38am
julieneaman's picture
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Joined: 01/11/2004 - 09:00

Tamie,
First off, congratulations! It certainly sounds promising. I would also think a skin test is in order b/f heading for the food challenge or will they do that the same day? Last summer ds went for a peanut challenge and there was a little girl there challenging egg who passed with flying colors! We didn't fare so well. The challenge can take a long time. Bring books, games, etc. BTW, you said dd is pa so beware in the waiting room for others challenging peanut.
Julie

Posted on: Fri, 01/06/2006 - 3:57am
BS312's picture
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Joined: 09/05/2001 - 09:00

DD (PA, TNA, dairy and egg allergies) tested low enough by RAST for an egg challenge two years ago (at age 6). We did not do a skin test because there is a high rate of false positives. That is, the skin test can remain positive for a long time after a person loses an allergy as judged by lack of reaction to eating the food.
The challenge took place in the allergist's office (in a hospital) with a nurse practitioner in attendance and the allergist in the same clinic area. It was very safe. We were asked to bring homemade french toast (bread that we knew was safe dipped in one whole egg and fried in safe oil) with safe syrup so that she wouldn't hate the taste of egg which she had never eaten before. We started with a tiny amount and over the course of one and one half hours she ate about three quarters of one piece of french toast. She actually liked it.
Near the end of the challenge, she started to complain of abdominal pain and nausea. This was considered a positive reaction and she was still considered allergic. The symptoms seemed to improve after some Benadryl. That was it: no hives, no trouble breathing, etc. We have been avoiding eggs since then (just as we did before the challenge), and her RAST level has risen slightly (around 2). Every year we repeat her RAST and when it falls below 2 we plan to do another egg challenge.
The funny thing is that the night of the challenge DD developed a fever, nausea and vomiting which were considered to be viral. So we don't know if her "reaction" was a true egg allergy or just the beginning of a viral gastroenteritis. We haven't been more aggressive about pursuing another egg challenge sooner (even though I think she is probably not still allergic to eggs) because it is not that difficult to live with an egg allergy when you are also avoiding dairy, peanuts and tree nuts.
Hope this helps and good luck!

Posted on: Fri, 01/06/2006 - 5:12am
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Joined: 01/03/2002 - 09:00

Hi, my dd passed her egg challenge at age 9! They don`t skin test after a negative rast because 50% of the time the skin test remains positive after they have outgrown the allergy, so a skin test is great for telling you about a new allergy, but does not tell you if they have outgrown it. My dd had an anaphylactic reaction to egg at age 2 1/2 requiring epi, so if there was anyone who wasn`t going to outgrow it, it was her. Her cap rast to egg at age 9 was 0.11 with normal at age 9 being less than 0.10. She had several different forms of egg during the challenge. She had egg salad with real mayonaisse, scrambled egg, and I don`t recall what else. They had me give a tiny amount, wait a few minutes (don`t recall if it was 15 or 30 minutes), came back in and checked her, gave a larger amount, and so on. The whole thing took about 2 or 3 hours. I also remember making some merangue for her, since it is from raw egg, so it would be a really good test, but I am not they ever had me give it. Anyhow, she passed and that was a year ago.

Posted on: Fri, 01/06/2006 - 11:34am
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Joined: 11/13/2005 - 09:00

Carefulmom: Do you remember your daughter's RAST number for egg, when she was young?

Posted on: Fri, 01/06/2006 - 11:37am
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They didn`t have a cap rast back then. She had one at age 5 and I think it was a class 2.

Posted on: Fri, 01/06/2006 - 11:40am
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Oh, sorry he did not do a rast when she was younger (back before cap rast) because she had had an ana reaction and had a positive skin test, so what was the point. He did the cap rast at age 5 to see if she was outgrowing it, since the skin test often remains positive.

Posted on: Fri, 01/06/2006 - 11:44am
mharasym's picture
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Joined: 04/20/2001 - 09:00

Like BS312 we did our challenge with French Toast. RAST was in acceptable range for testing. We cooked 1 slice of safe bread dipped in 1 beaten egg mixed with a little water and fryed in butter at home and brought to hospital (Allergy Clinic) to eat. (I can't imagine anyone diving into scrambled eggs who have never had them - I think the french toast is a better idea)!Also brought safe syrup. Started with a piece the size of a pencil eraser. Waited 15 minutes. Then a piece twice the size of a pencil eraser. Another 15 minutes. Then double that amount, etc. until we got to the 1/4 of a piece of french toast (equavalent to 1/4 cooked egg) and then the doctor said he was starting to react. I didn't even see it, but he noticed the very beginnings. Change in attitude (wanted to leave NOW), glistening eyes, restlessness, very slight sniffles. He said it was the start of anaphylaxis so in went the epi, steroids and another medication I can't remember. We had to wait 4 hours (good think we brought movies with us - it was the year of Lion King so that was a while ago!). After 4 hours we were allowed to leave, but he did need to be on steriods for 5 days after that. For us, no go. He's 13 now and his RASTS are too high to challenge again. We'll do one more RAST next year and then that will be it. He's probably a lifer!
Margaret
P.S. The only downside for us - to this day, he hates the smell of syrup!

Posted on: Fri, 01/06/2006 - 11:51am
Carefulmom's picture
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Joined: 01/03/2002 - 09:00

I think we may have done French toast also for the challenge. I really can`t remember. She loved the scrambled eggs.
Allergists vary a lot in how low the cap rast has to be before they will do a challenge. For example, I read in a FAAN newsletter an article by Dr. Wood who is really well respected, and he said that he will do a challenge if there is a 50% chance the person will pass. I was floored. So it is key to find out what your child`s cap rast really is. "An acceptable level" could mean it was 2.0 with normal being less than 0.10. That would mean it is 20 times normal, yet some allergists will do a challenge at that level. Our allergist will not do a challenge unless he is 98% sure the person will pass. So we have to wait longer for our challenges. Dd had a cap rast to milk of 1.02 and he said it was too high for a challenge. Later she had an inadvertent exosure (incorrectly labeled product) and had a reaction. So he was right. Lots of allergists would have challenged her at that level of 1.02. And she would have failed. So to the person who started this thread, maybe you should find out what the cap rast really is?
Surprisingly, I did not have any anxiety over the egg challenge, even though she had previously had the anaphylactic reaction. The reason was that I saw the cap rast and how low it was. I was almost positive she would pass.

Posted on: Fri, 01/06/2006 - 12:12pm
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Joined: 11/13/2005 - 09:00

Carefulmom (again [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img])
I was reading somewhere an article about doing peanut challenges for RAST #'s less than 10! I was shocked when I read it. Does that ring a bell with you? Maybe Dr. Wood also made this statement?
My ds had a + number for milk but since he had been drinking it for over a solid year (and a lot of it), without reaction, the allergist told us not to stop giving him milk. Same thing with soy.
[This message has been edited by mommamia8 (edited January 06, 2006).]

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