negative skin & CAP RAST / positive oral challenge

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My 3+ year old tested negative for peanut on the skin test and CAP RAST (positive for cashews & pecans) but we did an oral challenge for peanut butter and after eating 2 mini ritz bitz with peanut butter she started breaking out in hives on her face. We stopped there and they gave her a shot and some oral meds. How common is it to be negative until an oral challenge? We have to retest at 5 I think but for now they said to consider her positive to cashews, pecans AND peanut butter. Has anyone else experienced this????

On Jan 7, 2002

Don't have any experience with this, but boy what a huge disappointment. Sorry for the bad news.

On Jan 7, 2002

Had your 3yo EVER been exposed to peanut before? If not, that might (still up for discussion on the boards) be why the tests were negative. Supposedly, you CAN'T react until you've been exposed at least one time prior. In other words, the first exposure cannot produce a reaction.

My 2yo (at the time) was skin tested - negative - but I don't consider that to be a true indication since he's never been exposed. I consider the skin test to be an exposure, but some people don't. I figure that if someone can have a reaction, especially anaphylactic, to a skin prick, then it's an exposure - some have reported anaphylactic reactions to skin prick tests.

My thoughts.

Sorry for the disheartening news.

Take care, Tammy

On Jan 7, 2002

Could she be reacting to something else in the ritz bitz cracker?

Just a thought.

On Jan 7, 2002

Quote:

Originally posted by mitch'smom: [b]Could she be reacting to something else in the ritz bitz cracker? Just a thought.[/b]

I was wondering the same thing (even though it is unlikely). Why didn't they use a peanut or peanut butter instead of something that has other ingredients?

On Jan 8, 2002

Katie's Mom, The same thing happened to my son. Three years after his first, and only allergic reaction and positive skin tests, he was retested. His skin test was negative and then his blood test came back negative. We then went to our area children's hospital for the oral challenge. Peanut was hidden in a food that he was given to eat every 15 minutes and monitored closely. After his second portion, he had a fairly severe reaction. It was very frightening. It turned out that the first dose had no peanut, it was used as a control.

Our allergist was as surprised as we were that Kevin had a reaction. He didn't really know why the skin and blood tests would be negative while Kevin was obviously still allergic. The only thing he could think of was an error in the blood test.

I'm sorry that you have had to go through this. It is very disheartening to think that your child may have outgrown PA only to have to see him/her have a reaction at a test. It has been 2 years since Kevin's oral challenge and he continues to have positive skin tests. We have not redone the blood test.

It was difficult for Kevin too. After the failed food challenge the allergist suggested we wait two years and retest him. Later in the week he told me that he never wanted to be 6, he would skip right to 7 so he wouldn't have to have another oral challenge. He still says that he'd rather never eat peanuts or anything with peanuts again than have to go through another oral challenge.

On Jan 8, 2002

We too, had the same situation this past year, negative skin & RAST test. When we went to see the dermatologist, our seven year old has eczema, the dermatologist said "those tests lie". He feels eczema is a complicating factor and we should only accept that the allergy was resolved after a peanut challenge. The peanut challenge produced intense abdominal pain and an overall body flush. He DOES have a peanut allergy. Thank God we followed up with the challenge. There wasn't any information available to explian why this situation had occurred nor often it occurs. I am looking for info and will share any I get with you.

On Jan 8, 2002

Thanks for the replies. Yes, Katie had been exposed more than once prior to all of the testing and just said she "didn't like it" (pb & j sandwich) she also had cookies with pb in them at least once (prior to knowing her allergy to cashews/pecans). Once that happened we considered her allergic to ALL nuts so it doesn't change our routine now that we've had the oral challenge. It is disappointing though - we were hopeful it would be just cashews & pecans (less chance of exposure on a day to day basis). Oh well! It will be interesting to see what her cap rast and future tests in 2 years will show! Thanks for the replies!

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