need help with peanut testing results and drs advice!

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Hi, I was hoping some of you could help me with this. I had my son retested for peanut allergy a few weeks ago. He was tested last when he was about 3, now he is about to turn 5. His had the skin test at the allergist office which came back positive. We then did the blood test which came back at 3.46/506. The dr called and said that at this level we could restest and consider food challenge in 3-6 months if the levels continue to go down. I was under them impression that this was not a very low level. Isn't this still in the moderate category? His levels did go down from about 4. something the last time we tested, but I am just wondering why they would recommend food challenge at this level. I am worried. Thanks for any advice

On Jul 22, 2005

Hi! I'm not sure if all of the allergist's standards are the same for food challenges or if the are individualized. My dr. told me that if ds's levels ever reached below 2 he could undergo a food challenge. But, I have also heard some dr's won't food challenge unless it is under 1 so it doesn't seem to be a uniform # across the board between drs... Sorry I can't be of more help but good luck with your decision. If we ever reach that point ourselves I think I am going to need to be medicated for anxiety the day of testing! Best wishes!

On Jul 22, 2005

My doctor will not do a food challenge until the blood test shows "normal/no allergy" levels in addition to the skin test being negative.

My daughter is egg and P/TN allergic and her last blood test showed that she may have outgrown her egg allergy but the skin test showed a slight reaction. I was sent off with a "see you next year"! Not a biggie, I am SO used to keeping eggs out of her diet, another year won't bother me a whit!

Either way, go with your gut. If you are not comfortable with a food challenge yet, you don't have to do it.

On Jul 22, 2005

I would definitely not do a challenge. If his body is trying to outgrow the allergy...which is a possibility since the level went down, keeping him away from peanuts will allow his body to "forget" the allergy and reduce the antibody level. There is a very good possibility he will not pass the challenge. If he fails the test, his level could go up again.

My daugther went from a 5.48 last year to a 3.86 this year and her doctor did not give me any false hope that she will definitely outgrow the allergy, although I am hoping and praying she will.

On Jul 23, 2005

I think that once a child hits 5, a doctor is willing to do a challenge based on where their immune system is and the fact that they'll be entering school. Many parents want to know before they send their child off to school and to determine if their child needs to be at a peanut-free table.

I included a study that references 50% of children with 5 IGE or below having a chance of outgrowing the allergy. Your child is at that level, which is probably why your allergist would do a challenge.

Personally, I would wait til they were at least down to a Class 1. I think your child is still considered a Class 3, which is Moderate. No harm in waiting another year and retesting...

My other concern would be the child "redeveloping" the allergy. I wonder if these kids that are considered to "redevelop" their allergy ever really outgrew it. Maybe they were challenge at a low level but didn't really outgrow it completely.

This is just my opinion...Good luck with your decision! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Ree

[b]The natural progression of peanut allergy: Resolution and the possibility of recurrence.[/b]

Fleischer DM, Conover-Walker MK, Christie L, Burks AW, Wood RA.

Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

BACKGROUND: It was once thought that peanut allergy is a lifelong problem. We previously reported that about 20% of children outgrow their peanut allergy and that more than 60% of patients with a peanut-IgE level of 5 or less passed an oral challenge. OBJECTIVE: The goal of this study was to further describe the natural progression of peanut allergy by reviewing patients who have undergone oral peanut challenges since the previous study. METHODS: Patients with peanut-IgE levels of 5 or less were offered a peanut challenge. Those who passed were further evaluated by questionnaire to assess reintroduction of peanut into their diet and whether any recurrence has occurred. RESULTS: Eighty-four patients were evaluated, and 80 underwent complete analysis. Fifty-five percent with peanut-IgE levels of 5 or less and 63% with peanut-IgE levels of 2 or less passed challenges, compared to 61% and 67%, respectively, in our previous study. The 4 additional patients passed peanut challenges in this study after previously failing. Three patients with initial anaphylactic reactions and 2 patients with initial peanut-IgE levels greater than 70 passed their challenge. Follow-up of those who passed in both studies showed that the majority of patients reintroduced peanut into their diet, but that continued label reading, infrequent/limited ingestion, and aversion to peanut were all common in this population. Two patients had suspected subsequent reactions to peanut after passing their challenge. CONCLUSIONS: [b]Patients with a history of peanut allergy and peanut-IgE levels of 5 or less have at least a 50% chance of outgrowing their allergy. [/b] Recurrence of peanut allergy may occur but appears to be uncommon.

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