New Here & What is RAST Test (& How Predictable is the Progression of PA)?

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Hi! I just found out that my daughter has a severe peanut allergy as was determined by a skin test. I suspected something was up because she hated peanuts from a very young age. Then about a month ago, she mentioned that she got a sore throat when she accidently ate something with peanuts. So I took her to the allergist & he did the skin test thus the determination that her peanut allergy is severe. However, I would like to find out more about the severity of her PA. What is the RAST test (is it a blood test)? And I've been wondering what the chances are of my daughters PA of progressing to very severe (i.e. allergic to the touch or smell of peanuts). The preschool my daughter attends occasionally serves peanut butter & peanut butter cookies to the other kids but the teacher & cook are careful not to serve peanut products to my daughter. Although this arrangement has worked out great so far, I wonder if her PA could advance just by having peanuts nearby even though the touch or smell of peanuts has not caused a problem with my daughter in the past. What are your experiences with PA? What were the initial symptoms and did the PA stay the same or get worse, and if it did change, what type of exposure brought it on. Can it be enough for some people (who have shown no reaction to the touch or smell of peanuts) just to not eat peanut products even when others are. Any advice or stories would be greatly appreciated! --Amy

On Mar 29, 2002

Amy, first of all, a warm welcome to you! [img][/img]

No question is either strange or "dumb" here... (or anywhere else, in my opinion [img][/img] ) and testing is one issue upon which even a great many doctors disagree. Most of us here would rather rely on blood testing (RAST testing.... which detects peanut-specific antibodies...) This test is a basic measure of how "threatening" your child's immune system thinks the protein is... but unfortunately, it is not the whole story either in severity, longevity, or sensitivity with respect to a food allergy. Many physicians feel that it is slightly more accurate than skin testing for food allergens, but neither one is perfect. False "negatives" are rare with either test, but false positives abound. One serious advantage that the RAST has over skin testing is that it is undeniably risk-free to your child. Skin testing can (rarely) result in serious allergic reactions, so many of the parents on these boards avoid having it done. It sounds like there is no doubt that your child is allergic. Does your family have epinephrine? If not, you should contact your physician and ask for a prescription for an epinephrine autoinjector. This is necessary for peanut allergic individuals because the next reaction could be nothing at all like the last one... a life-threatening reaction is ALWAYS a possibility, so you do need to be prepared for one. Insist upon this prescription- better to never need it and have it than the other way round. You should have a discussion with an allergist about this allergy, if you have not done so yet!

The "progression" of PA is highly unpredictable. Some people retain the tolerance you've seen throughout all of childhood and adulthood, in spite of many exposures.... some children's reactions worsen with every additional exposure. (I hate to tell you this, but at least anecdotally, the latter seems to be more common.) It sounds as though your child has tolerated minor exposures fairly well until now- but don't be shocked if that changes. Many children do until they begin developing additional allergies... and then everything seems to go haywire at once. (Our allergist likened this to the body being on "red alert" for allergens both old and new!)I would work toward a coherent policy for any and all care providers about peanuts and your child. You may want to change your "comfort zone" as you go- everyone else on these boards does on a regular basis! [img][/img]

Again- a warm welcome to you and your family. Other resources for you are from FAAN, at [url=""][/url] - they can be great, but at some point, you will begin to find your feet some and make your own decisions about what you are comfortable with. Just to be able to feel that you are making those decisions as well-informed as you *can* be helps you feel better, I know! [img][/img]

On Mar 30, 2002

Thanks for the info! Yes, I have 3 Epipens, and we do not go anywhere without one. We have already seen an allergist (he gave my daughter the skin test) but he did not mention the RAST test & I was the one that pushed for the Epipens right after the appointment. Although in many ways he (the allergist) seems knowledgeable about PA, I have to wonder if he's the best choice. Since he didn't mention the RAST test or Epipens, I wonder what else he might not have mentioned. Thanks again for the info!