Negative skin prick test

Posted on: Wed, 08/21/2002 - 7:32am
amymarie's picture
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pLooking for advice or, better yet, links to research on this issue. My son had a reaction to peanuts at just over 1 year old. He was tested-his blood test was negative his skin test was barely positive. I just had him re-tested. He is almost 3. His skin test came back negative totally-no reaction at all. The allergist stated that given the history, he does not have a peanut allergy. I was on cloud 9. then, I called FAAN to double check, someone on the phone recommended continuing carrying epis avoiding peanuts until he is 5 then doing a food challenge. While I appreciate this opinion, it seems unnecessary to continue buying epis avoiding the peanuts if he is no longer allergic. I have researched all I can have found no research indicating a negative can actually be wrong. Everything I have read is that if the blood skin prick test are negative their is no allergy. Does anyone know where this research is that indicates you can have both negative then have a reaction? Any research links is really what I am looking for. My allergist feels a food challenge is not necessary given my son's history. I wish they would perfect these tests! So frustrating. Thanks-Amy/p

Posted on: Wed, 08/21/2002 - 8:44am
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A negative skin prick test has a reliability of 95% accuracy (which means there's still a %5 change the result is not accurate) however I think that what FAAN told you is not unrealistic in fact waiting until his immune system is mature is frankly very advisable. I would weight the benefits vs the risks and I honestly think that waiting until he's 8 or more is a better option. Why? Because:
1) Peanuts are not such a good food nor necessary to have in order to grow healthy
2) I know it is a big hassle trying to avoid to eat peanuts but if he's not allergic the worst thing you did was depriving him for a few more years of a food he has a lifetime to enjoy.
3) Exposing him to the peanut protein when his immune system is still "maturing" can backfire.... you may remind the immune system of this protein he was once allergic to therefore giving up the possibility to outgrow it (and this happens only if you totally avoid it).
The decision is ultimately yours but if he was my son that's what I would do.... my son was allergic to milk as an infant I kept him off of milk for 2 straight years and was able to outgrow it, he's been skin tested for peanuts he's negative but not even in my wildest dreams I would even consider to let him sniff the stuff..... no way until he's much older that's what some of the allergist I've seen told me to do and did my own research as well. I hope everything will be fine for your son and good luck in making the right decision. Stay safe.

Posted on: Wed, 08/21/2002 - 12:53pm
Chris PeanutAllergy Com's picture
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Joined: 04/25/2001 - 09:00

Was the recent skin test done only once or was a second skin test done right away when the first skin test was negative?
Have you had a blood test done after the skin tests came negative?
If all skin tests are negative and if you get a negative blood test are you going to contact Dr. Sampson at Mt. Sinia and/or a highly qualified board certified allergist and find out about when to do a food challenge?
Let us know what you find out and good luck!
Stay Safe,
[email]Chris@PeanutAllergy.Com[/email]
The materials and other information provided by this Web site are for educational, communication and information purposes only and are not intended to replace or constitute medical advice or treatments.
------------------
Stay Safe,
[email]Chris@PeanutAllergy.Com[/email]

Posted on: Wed, 08/21/2002 - 1:32pm
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I heard tha 5% of kids with negative blood and skin test will become resensitized to peanuts after repeated exposure. Interestingly enough, our 10 year old neighbor was pa, his blood and skin tests came up negative, he passed a hospital food challenge, BUT being labeled NOT allergic and after several exposures (and 1 year later) he started to react to peanuts again.

Posted on: Wed, 08/21/2002 - 2:24pm
amymarie's picture
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Who is Dr. Sampson & how would I get in touch with him? I am in IL. The allegist I took him to is board certified. There is a lot more to this story but I just wrote it all out & then lost it, so I don't feel like retyping the whole thing-LOL. There are a lot of questions about whether he actually had a reaction or not. I want to know for sure. I am trying to do research & get the facts, which can be difficult with allergies! Do you have links for the studies indicating the immune system needs time to mature? I have not heard this. Thanks for all your posts. Amy

Posted on: Wed, 08/21/2002 - 2:51pm
Helen's picture
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Amy,
In case it's helpful, here's my child's history, which sounds somewhat similar: - My son had an ambiguous reaction to peanuts (was it really a reaction???) and subsequently tested very positive on the blood test and but negative on the skin test. On a repeat skin test, he tested positive. We waited two years, then retested - negative skin tests. Dr. did food challenge and he "passed". This was by a board certified, highly respected allergist. Either he was never allergic or he outgrew the allergy. He has since eaten peanuts without incident. Obviously, we feel VERY fortunate.
Helen

Posted on: Wed, 08/21/2002 - 2:57pm
amymarie's picture
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Hi Helen-how old was your son when he had his reaction & how old when he tested negative? how old is he now? Sorry to be so nosy! Just curious. This does sound similar. Our first skin test (positive) was also questionable, as the staff did not know what they were doing; they reapplied the peanut product twice to the same location. I have never been so frustrated with the medical profession as dealing with PA. This allergist I recently tried was very informed & really listened. I guess I trust him more than anyone I have talked to so far. I guess the next step is the food challenge. He just felt like this was not even necessary after reviewing his history. But, how can you just give them peanuts without the challenge, as a parent, you know? We shall see. It is looking good & sounds very similar to your case!! Amy

Posted on: Wed, 08/21/2002 - 11:36pm
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What I would do is to email Dr. Sampson and ask him to recommend a board certified allergist in your area. That way you know you are seeing someone whose knowledge is current. Or you could email him and ask him his opinion of your child`s situation, although it seems like it would be hard for him to give an opinion without actually seeing your child. I think Dr. Sampson is in New York. His email address is [email]hugh.sampson@mssm.edu[/email]. Let us know what happens.

Posted on: Thu, 08/22/2002 - 1:28am
amymarie's picture
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Carefulmom-i tried to email Dr. Sampson at the email you listed & it bounced. I doublechecked & I used the address you listed. Does anyone have another email I could try? Thanks-Amy

Posted on: Thu, 08/22/2002 - 3:28am
Carefulmom's picture
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I have emailed him myself at that email address and gotten a response from him, so I know that address is correct.
[This message has been edited by Carefulmom (edited August 22, 2002).]

Posted on: Thu, 08/22/2002 - 8:40am
amymarie's picture
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OOPS! I forgot the period inbetween hugh & sampson. Just re-sent my email! Thanks-Amy

Posted on: Thu, 08/22/2002 - 12:08pm
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My daughter, now almost 4, had only one reaction at around 2 years old.She had a negative skin and blood test about 3 months ago and was referred for an oral challenge. She made it through the entire first part of the challenge with no problem, then broke out in hives about ten minutes later. They still think she may outgrow, but for now, we're sticking with the epipens.

Posted on: Thu, 08/22/2002 - 1:58pm
ks65's picture
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Joined: 03/06/2002 - 09:00

Nava-
what does it mean when you say she made it thru the entire 1st process of the peanut challenge? If your child broke out in hives (even if it was 10 minutes) it sounds like he/she didn't make it thru the first part of the challenge? I am just a bit confused and would love to hear how your challenge was done. I know with my son (who is allergic to other foods at this time ...we haven't tested for Peanuts yet) he will eat the offending food and then break out in hives sometimes immediately and sometimes within 10 to 15 minutes, but we know it is attributable to the food he ate. could you explain how your challenge was done? Thanks!!

Posted on: Fri, 08/23/2002 - 1:29am
nava's picture
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She was given chocolate in increasing amounts at fifteen minute intervals- we didn't know whether or not there were peanuts hidden in them. This went on for about an hour and a half with no reaction. Then there is a break before the next part of the test. It was then that the hives appeared, and we found out she had been exposed to peanuts all along.

Posted on: Fri, 08/23/2002 - 9:42am
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Joined: 10/02/2001 - 09:00

Amy -
I hope you are still reading this thread. My son had a bad reaction after eating a peanut at 18 mos old. We know for sure it was the peanut and he has no other food allergies. His skin test at the time was a 4++. The allergist did not do the CAP RAST then because she doesn't like to do them on children under 2. He had one other reaction before he turned two. At 2 1/2 we did the RAST and it came back negative to peanuts. We live in NJ. My local allergist sent us to see Dr. Sampson at Mt. Sinai. He redid the RAST and did a skin test - both were negative. Though he believes Jack has outgrown his allergy, due to the fact that you are not suppose to give peanuts to children under the age of 3, he will not do a food challenge until Jack is 4 years old. In the meantime we are suppose to act as if Jack is still allergic. We still carry epi-pens, Jack still wears his bracelet, I am training his new teacher next week. ( we have not told many of our family, friends and especially Jack's school anything about him being negative yet so as they don't "relax" around him) and now we wait. Jack turns 3 in October. Dr Sampson said he will re test Jack next summer and if the results are negative again we will schedule the challange for the fall.
That has been my experience with negative results and Dr. Sampson. BTW Dr. Sampson is the greatest! His staff is excellent and he really know his stuff. We are lucky to live in his back yard so to speak. If you have the means I would defintely suggest seeing him or at least contacting his offiec.
Good Luck
Dani

Posted on: Fri, 08/23/2002 - 11:25am
amymarie's picture
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Dr. Sampson did email me back-HOW NICE of him. He stated if he were Joshua's doctor, he would do another skin test & if it was negative do a challenge. So, I am going to contact my allergist & see if he will do this, which I am sure he will. I will let you know how things turn out! By the way, my son turns 3 in October also & my new baby to be born in December is going to be named Dani (Danielle). [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Amy

Posted on: Fri, 08/23/2002 - 12:14pm
Anonymous's picture
Anonymous (not verified)

I am really glad that this is currently being discussed. My son, age 6, had many minor reactions to peanuts/pb from age 2 to age 4. I would try to sneak it to him in various ways but he would always refuse to even swallow the first bite. Once it even touched his lips, he would experience coughing, major pain in his throat, and excessive saliva. The last time he was directly exposed to peanuts was at a neighbors house with a pb cracker. She said he took one bite and spit it out immediately. He ran home and experienced all of the above mentioned with diarrhea. At around that time he consumed four small pieces of cashews and experienced coughing, throat swelling, diarrhea, vomitting, hives, lethargy, drop in blood pressure, and excessive saliva (we had to use a bowl to catch it all as it completely drenched the towels we were using). We did not have the Epi at the time so we were extremely lucky that the Benadryl was affective. During the first allergist visit he tested positive via a skin prick to peanuts, cashews, and pistachios. His wheals were approximately the size of grapefruits. A year later, he was again skin tested but only tested positive to peanuts and pistachios (questionably sesame and almonds). He reacted to the skin test also with itchy throat, coughing, and diarrhea. Several months later (age 5) he ate some Swiss Miss pudding and everywhere the pudding touched his skin around the mouth, the skin was red and puffy. We found out later they make a chocolate/pb pudding on the same lines with no labeling. However, this year he had the RAST test and tested negative to peanuts but showed positive to pistachios and cashews. We have contemplated doing a challenge but my son is extremely scared and told me he doesn't want to do one. I honestly believe he would go into shock if he KNEW he was going to consume peanuts. My husband and I decided we would wait another year, re-test, and then consider doing a food challenge.

Posted on: Fri, 08/23/2002 - 12:18pm
Anonymous's picture
Anonymous (not verified)

One other thing I thought I might mention is that he does have asthma also. Does your son have asthma? Ours didn't show up until he was around four years old. Let us know if and what your son's results are.

Posted on: Fri, 08/23/2002 - 1:25pm
amymarie's picture
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Naomi-Thankfully, my son does not have asthma. My twin does & environmental allergies run in our family, but so far Josh seems only allergic to peanuts. And, possibly cats, which all my bro. & my sis are allergic to. Amy

Posted on: Fri, 09/13/2002 - 7:59am
amymarie's picture
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Update-Josh had his peanut challenge today! I was a wreck. Great news. He passed with no reaction. He loved the peanut butter & kept trying to get more before the time. I was SO stressed, but now am so glad I did it. I asked the doc if he thought he outgrew it or never had it, since he had a questionable reaction. He said it was hard to tell as PA is misdiagnosed a lot in young children. BUT, he does not have it now. I am so happy. Thanks for all the support. I was going to post under the food challenge thread I started but can't find it. Keeping you all in my thoughts. My doc did not feel a new blood test was necessary, so we did not do this. Amy

Posted on: Fri, 09/13/2002 - 8:21am
smack's picture
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[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]Most excellent!
Congratulations, YA HOO!

Posted on: Fri, 09/13/2002 - 2:32pm
kcmom's picture
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Joined: 12/18/2001 - 09:00

So happy for you Amy! And your son! You must feel like a huge weight has been lifted off your shoulders! Take care and best of luck!!
[img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]
kcmom

Posted on: Sat, 09/14/2002 - 3:35am
amymarie's picture
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Thank you KCmom & Smack, for the good wishes. Amy

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