Learned something new about re-sensitization after outgrowing peanuts.

Posted on: Mon, 11/20/2006 - 10:32pm
AmyR's picture
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Joined: 09/26/2000 - 09:00

Posting new thread because I got some interesting information this morning.

I had another thread going about a concern I had with DS who outgrow his peanut allergy and now refuses to eat anything with peanuts. I had heard/read the allergy could re-appear if I didn't feed DS peanut products on a "regular" basis. I was getting worried that his allergy could come back and we wouldn't know about it.

Well, I logged a call into my allergiest this morning to discuss this topic. He told me that the only concern is with children who had a positive skin test but then took the oral challenge anyways and passed. He said if both the skin test and oral challenge were negative then there is no concern. It is the people who had a positive skin test and a negative oral challenge who need to be concerned with re-sentization and, therefore, should peanuts on a regular basis. I was not aware of this detail and thought others should be aware also.

Posted on: Tue, 11/21/2006 - 12:35am
anonymous's picture
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Joined: 05/28/2009 - 16:42

How many would risk an oral challenge with a positive skin test?

Posted on: Tue, 11/21/2006 - 1:19am
AmyR's picture
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Joined: 09/26/2000 - 09:00

Perhaps if the child has a negative blood test (and reaction free for a period of time)but still has a positive skin test, there would be a reason for an oral challenge. I remember reading that you can have a false positive skin test and even have this result after outgrowing the allergy. I believe a blood test is more accurate anyways. In addition, I just did a search and came up with the following informatin on [url="http://www.drbarryzimmerman.com."]www.drbarryzimmerman.com.[/url] It reads:
LOSS OF REACTIVITY TO PEANUT WITH A POSITIVE SKIN TEST. There are two ways a child can outgrow sensitivity to peanut. In the first instance, as described above, the child actually loses any detectable IgE antibody to peanut. However in other cases, the child maintains the positive skin test and RAST to peanut but loses clinical sensitivity. That is formally proven in the study described below. It is not known whether there is a difference in the long-term outcome of these two types of peanut sensitive children but some children do have a recurrence of their peanut sensitivity over time.
I also found some other cites that seem to to contradict what my allergist told me today. Although not a large population, it seems that some people who had a negative blood test and negative oral challenge did actually redevelop the allergy.

Posted on: Tue, 11/21/2006 - 12:35am
anonymous's picture
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Joined: 05/28/2009 - 16:42

How many would risk an oral challenge with a positive skin test?

Posted on: Tue, 11/21/2006 - 1:19am
AmyR's picture
Offline
Joined: 09/26/2000 - 09:00

Perhaps if the child has a negative blood test (and reaction free for a period of time)but still has a positive skin test, there would be a reason for an oral challenge. I remember reading that you can have a false positive skin test and even have this result after outgrowing the allergy. I believe a blood test is more accurate anyways. In addition, I just did a search and came up with the following informatin on [url="http://www.drbarryzimmerman.com."]www.drbarryzimmerman.com.[/url] It reads:
LOSS OF REACTIVITY TO PEANUT WITH A POSITIVE SKIN TEST. There are two ways a child can outgrow sensitivity to peanut. In the first instance, as described above, the child actually loses any detectable IgE antibody to peanut. However in other cases, the child maintains the positive skin test and RAST to peanut but loses clinical sensitivity. That is formally proven in the study described below. It is not known whether there is a difference in the long-term outcome of these two types of peanut sensitive children but some children do have a recurrence of their peanut sensitivity over time.
I also found some other cites that seem to to contradict what my allergist told me today. Although not a large population, it seems that some people who had a negative blood test and negative oral challenge did actually redevelop the allergy.

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