Latest CAP RAST score

Posted on: Sun, 02/19/2006 - 12:23pm
tracy's picture
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Joined: 02/03/1999 - 09:00

My son turned 8 years old recently. He had his first (and only) reaction to peanuts (a peanut butter cookie) when he was 13 months old (he vomited, his face swelled and he got some hives). At that time we got a RAST test (not CAP RAST) and it was a Class V (don't remember the exact numbers). We were told by his allergist that he would never outgrow the allergy. (This was in 1999 before there were studies indicating that some children do outgrow the allergy.)

We have a different allergist now. When our son turned five he got a CAP RAST test done and it was an 8. His latest test at eight years old came back at a 5.

My understanding is that his level is still in a very positive range. We're encouraged that his numbers continue to go down and that he hasn't had any reactions for 7 years. He eats lunch at his school cafeteria with other children who eat peanuts and peanut butter around him on a daily basis. He's always been around peanuts, so we don't think he's very sensitive. But since he still has a definitive positive CAP RAST result it doesn't appear that he's outgrown the allergy.

The allergist wants us to continue like we have been (avoiding peanuts) and retest him in 3 years. Not a problem... nothing has changed.

I don't know if I should remain hopeful that he'll outgrow the allergy or not. Does anyone have comments on his situation?

Thanks,

Tracy

Posted on: Sun, 02/19/2006 - 9:41pm
Julius7us's picture
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Joined: 10/19/2004 - 09:00

Hi, my son was tested at 11 months. Not because he had peanuts but because he always had a rash and eczema. 7 years ago nobody ever told me not to eat peanut butter while I was pregnant and breastfeeding. I feel guilty now though.
His first RAST test was 2 years ago and it was 1.6 for peanuts. That is Level 2 which his allergist said is serious enough for an epi-pen and total avoidance of nuts.
Last year he mentioned the new findings that some kids can outgrow the allergy. He mentioned that it was the kids that had only had skin reactions and not anaphal???,,,(I can't spell that word this morning) We retested him 2 months ago and he was very encouraged because it has dropped to 1.1. Because that is still level 2 we are still to treat him as we did when it was 1.6. He wants a negative RAST and then a negative skin test before he would challenge test him. We will retest his blood in another 2 years.
I thought Level 5 was still quite severe. You said you don't limit your son on where he sits at school and his second hand exposure? Debi

Posted on: Mon, 02/20/2006 - 12:16am
Sirimon's picture
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Joined: 02/01/2006 - 09:00

From data published by Dr. Sampson in 2001, 61% of children with peanut IgE less than 5 kU/L (which I think is your case) passes thier oral peanut challenge test and were considered "outgrown" their PA. The initial peanut IgE level less than 10 was a good predictor, although there were few that had very high initial level that outgrew.
He said that kids with skin reactions only have a better likelihood of outgrowing, but I also read somewhere (medical liturature) that even a kid with initial anaphylaxis did eventually outgrew the allergy.
Dr. Sampson did oral food challenge (in the study) for kids with peanut IgE <20. He recommended that any children older than 4 with level less than 5 should be considered for oral food challange.
If I were you, I'll be jumping up and down now b/c I see light in the tunnel. (my daughter's 16). It may even go down further with the next test.
Good Luck [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Mon, 02/20/2006 - 12:34am
Julius7us's picture
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Joined: 10/19/2004 - 09:00

That is good to know. It is amazing and almost scary in the differences between what different allergists tell their patients, isn't it? I think my Drs. reasoning for not doing the oral challenge is because he said that the more accidental exposure they have, the less likely they are to eventually outgrow it. Debi

Posted on: Mon, 02/20/2006 - 12:59am
notnutty's picture
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Joined: 03/15/2004 - 09:00

Quote:Originally posted by Julius7us:
[b]...I think my Drs. reasoning for not doing the oral challenge is because he said that the more accidental exposure they have, the less likely they are to eventually outgrow it. Debi[/b]
Thus the reason many of us do not allow incidental exposure through contact. Being exposed through second hand exposure can increase the IgE levels, even though reactions are not present. That is what I have been told, although this thought process may vary from doctor to doctor.
Donna

Posted on: Sun, 02/19/2006 - 9:41pm
Julius7us's picture
Offline
Joined: 10/19/2004 - 09:00

Hi, my son was tested at 11 months. Not because he had peanuts but because he always had a rash and eczema. 7 years ago nobody ever told me not to eat peanut butter while I was pregnant and breastfeeding. I feel guilty now though.
His first RAST test was 2 years ago and it was 1.6 for peanuts. That is Level 2 which his allergist said is serious enough for an epi-pen and total avoidance of nuts.
Last year he mentioned the new findings that some kids can outgrow the allergy. He mentioned that it was the kids that had only had skin reactions and not anaphal???,,,(I can't spell that word this morning) We retested him 2 months ago and he was very encouraged because it has dropped to 1.1. Because that is still level 2 we are still to treat him as we did when it was 1.6. He wants a negative RAST and then a negative skin test before he would challenge test him. We will retest his blood in another 2 years.
I thought Level 5 was still quite severe. You said you don't limit your son on where he sits at school and his second hand exposure? Debi

Posted on: Mon, 02/20/2006 - 12:16am
Sirimon's picture
Offline
Joined: 02/01/2006 - 09:00

From data published by Dr. Sampson in 2001, 61% of children with peanut IgE less than 5 kU/L (which I think is your case) passes thier oral peanut challenge test and were considered "outgrown" their PA. The initial peanut IgE level less than 10 was a good predictor, although there were few that had very high initial level that outgrew.
He said that kids with skin reactions only have a better likelihood of outgrowing, but I also read somewhere (medical liturature) that even a kid with initial anaphylaxis did eventually outgrew the allergy.
Dr. Sampson did oral food challenge (in the study) for kids with peanut IgE <20. He recommended that any children older than 4 with level less than 5 should be considered for oral food challange.
If I were you, I'll be jumping up and down now b/c I see light in the tunnel. (my daughter's 16). It may even go down further with the next test.
Good Luck [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Mon, 02/20/2006 - 12:34am
Julius7us's picture
Offline
Joined: 10/19/2004 - 09:00

That is good to know. It is amazing and almost scary in the differences between what different allergists tell their patients, isn't it? I think my Drs. reasoning for not doing the oral challenge is because he said that the more accidental exposure they have, the less likely they are to eventually outgrow it. Debi

Posted on: Mon, 02/20/2006 - 12:59am
notnutty's picture
Offline
Joined: 03/15/2004 - 09:00

Quote:Originally posted by Julius7us:
[b]...I think my Drs. reasoning for not doing the oral challenge is because he said that the more accidental exposure they have, the less likely they are to eventually outgrow it. Debi[/b]
Thus the reason many of us do not allow incidental exposure through contact. Being exposed through second hand exposure can increase the IgE levels, even though reactions are not present. That is what I have been told, although this thought process may vary from doctor to doctor.
Donna

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