Please Explain Class Number

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[This message has been edited by Flounder (edited January 08, 2007).]

On Oct 4, 2006

Ds was only a class 3 at the highest of his pn allergy, I think he's now a class 2, we do not take chances with nuts of any kind. When he was originally tested at 18 months, he was a class 1 to soy, allergist said he should be fine with it, however soy oil gave him hives, and once we cut out the lecithin, his eczema went away. Now at age 5 1/2 he can tolerate small amounts of lecithin in hershey's chocolate. So I think a lot depends on your allergist's advice and your own observations. We used to have to limit dairy with ds too (eczema again), it was not until he was four that we didn't have to eat dairy free from tues to thurs so he could have homemade pizza on fridays. It was at this age that we started to let him drink regular milk if he wanted instead of rice milk, now he rarely asks for rice milk and probably drinks a gallon and a half of milk per week. Things that flared his eczema usually ended up in skin infections and made him quite ill, so we just did what we felt was necessary. It seems he's grown out of some of his sensitivities to milk and soy.

On Oct 4, 2006

my girls have several class 2 and 3 allergies that actually give them no problems at the present time. one daughter (the youngest) still battles eczema flare ups that i attribute (with no real proof) to her soy, egg, wheat allergies, for example. the eczema flare ups are fewer and more far between than when she was younger. my older daughter also has several class 2 and 3's that give her no problems. in all they allergic to some degree to wheat, soy, egg, milk, tomato, chocolate, and many molds, grasses, pollens, plus housedust and dustmites. i think that was the complete list...not sure without looking at the paperwork.

i actually saw their skin tests and the reaction on the skin to the soy, for example, was HUGE. for whatever reason, which i still cannot understand, soy does not seem to cause them any ill effects. in fact, their formula as babies was completely soy based??? i'm sure that's why their poor little skin looked like ground beef back then too...but at the present time, soy (and the others) do not cause any type of reaction and definitely not anaphylaxis.

for us, the only allergen we must avoid at all costs is peanut. their reactions in the past and current allergy testing tell us that. incidentally, my daughters were both re-skintested a few years back for peanut and reacted to the skin test! yikes!

from what i read here at pa.com, i would have to say it sounds like my kids' situation with the soy, wheat, egg, milk, etc is not the norm. to "seem" to be allergic to those things through testing but to react very little to none at all is weird but that's the situation we have.

i kind of wonder how many of us are "allergic" to things we eat and breath every day, kwim?? when my girls' came up with an "allergy" to chocolate and tomato, for ex, at their last allergy appt., we laughed out loud. it just didn't seem possible.

i guess the trick is to figure out which allergies are serious and which ones are more of an irritant, kwim? when my girls were younger, for ex, they did seem to have a mild reaction to egg (redness around the mouth, tingling in the throat) which has gone completely away. even our allergist deems them no longer allergic to egg, even though the skin test does not seem to say that.

confusing.

[This message has been edited by joeybeth (edited October 04, 2006).]

On Oct 4, 2006

I really feel for you and what you are going through with these multiple food allergies. I can't imagine finding out my dd reacted to so many.... I"m not going to be alot of help but I'll tell you what I do know. DD is class VI w/ana hx to peanuts, tests 2-3 on most tree nuts (which we totally avoid and as far as I can remember has never had. She had her first ana rx to peanuts at 18 mos and we had yet to give her nuts. She actually snuck a piece of halloween candy (a snickers) from my mom's house when she had her 1st rx) and is a class III to soy and we do avoid soy butter or things w/ soy in top ingredients, but she doesn't react to soy like she does nuts. I initially noticed if soy was in the top three ingredients she would become red around her mouth but never ana or anything like nuts. Either way- we now avoid it as much as possible. Never as stringent as what we are with nuts. I'm sorry I can't give you any answers on all the new allergies your dd has been dx with. I hope others can. But did want to let you know we are thinking of you and feel for your position. I can't imagine having new twins, a 2yrold?, and a dd w/all these new allergies.

On Oct 5, 2006

Well, maybe I can at least explain why I made the statement...

This was regarding feeding foods for which an allergist has indicated no particular course of action AND there is no really obvious reaction history... for things like that which are class 1, I don't worry. Class 2, I begin to be a little more cautious. Class 3? I need a challenge in a Dr's office to feel happy about feeding those things, if I ever do.

This is because with a RAST, the higher the number, the more likely a clinical rxn becomes. Of course you don't treat pn, tn or shellfish that way. That wouldn't be very smart. Sesame is another one I would be a little more concerned about, even with a low RAST. But many foods just don't have any kind of real predictivity at low RAST values... And some people make IgE to pretty much anything... but it doesn't mean that they have a clinical allergy, for whatever reason.

It is terribly confusing, I know. I just wanted you to understand why I made that particular statement. It was about test results that apparently fly in the face of experience.

On Oct 5, 2006

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[This message has been edited by Flounder (edited January 08, 2007).]

On Oct 5, 2006

Quote:

Originally posted by Flounder: [b]I need help understanding allergy class numbers. I know that they relate back to the blood test numbers and I think I understand that they are only indicative that an allergy exists and how likely it will be that one might react to an allergen.

I read in another thread somebody (I think it was Corvallis Mom) mentioned that you should be more concerned with anything that is over a class 2. I want to know if this is only with a reaction history or is it regardless of any previous reactivity? And extend this thought to anything that is a class 1 without clinical history (obviously a class 1 with clinical history is another story).

Last question, how much reaction warrants removing the food completely from the diet? Keep in mind I am coming from the perspective of a parent of a child that is severely allergic to many foods. If there is a possibility of keeping anything safely in her diet it's a better chance at proper nutrition...I want to know if there is any way to know for absolute certain that it is safe to continue eating these types of foods. Is there any way to predict whether she will sensitize more to these or any other foods?

I thought I knew the answers to these questions, but recently my whole allergy world got turned upside down - so I'm hoping some of you will have some expertise in this area [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img].

Thanks!

Siobhan[/b]

I'm probably not much help here as I think they use different classifications here in Ireland and UK. Or at least in overall IGE level. I seem to recall having a conversation with a friend in SF whose child has allergies and the overall IGE was in the 10 thousands. Here in Ireland the scale doesn't go up that high. The highest the immunologist here has ever seen was 3 or 4000 and that was with a child with severe immuno impairment. They had some sort of genetic disease. And if the overall IGE scales are different the Class Numbers may be different too.

I can tell you this though. If your child is as reactive as mine was (and still is to a lesser degree) then at the first sign of any reactions (whatever it was) I immediately stopped all exposure to that item. Because from experience I knew that repeat exposure would only make the reaction worse and worse and worse. This is what happened with wheat. Now if he ate anything with wheat in it it would be touch and go whether he would go into anaphylaxis.

Find a good, safe multivitamin and calcium supplement to make up for any glaring deficiencies. Try to get them to eat as much fresh fruit and veg as possible. And I'm sorry Siobhan but I can't rememeber the age of your allergic child. At certain ages you can consider supplementing with things like a good probiotic, digestive enzyme and Essential Fatty Acids. All which were essential in seeing a big improvement in R.

Barb

On Oct 5, 2006

DD had her anaphylactic reaction just after she turned 1. This is how we found out she was allergic to peanuts. I am talking facial swelling, unrecognizable, throat swelling, rush to ER, strapped to a board and pumped full of steroids, benadryl and epinephrine. So they did a RAST test and found her to be a Class 2. We have totally avoided all nuts, and her most recent RAST has her at a Class 6. Her allergist stated to the school that any reaction would be devastating. But then again, so was her reaction at a Class 2. I think it just shows that reactions can change.

On Oct 6, 2006

There must be a couple of different classifications used. One allergist here uses a scale of 0 to 4+ when doing skin prick tests. This is based on the size and shape of the test site. Another uses a ruler with holes in it of various sizes and measures the size of the wheal (redness/puffiness) in millimeters.

Then you have RAST testing, which I would have thought would be a universal scale and most people just report it in numbers. My son is 18.5 to peanuts, 7.25 to egg and 0.81 to milk. Alot of people around here just use the numbers without the value/units. His peanut is 18.5 kU/L or 18,500 U per liter. I'm not sure what the U is. From what I've gathered, its just a standardized unit that measures the number of IgE antibodies produced by an allergen. This is why one of the posts above mentioned RAST in the tens of thousands. I hope that child/person RAST value was just U/L and not kU/L.

Looking at a copy of my son's report, it has the following:

Levels of Specific IgE kU/L - class - Description <0.05 - 0 - Negative 0.05-0.07 - 0/I - Equivocal 0.08-0.15 - I 0.16-0.5 - II 0.51-2.5 - III 2.51-12.5 - IV 12.51-62.5 - V 62.51->100 - VI

This is why sometimes you hear people refer to the child is a Class 4 (IV) to peanut or Class 3 (III) to milk. And to add further confusion, I don't think it really matters which Class the allergy is. The values for a high risk reaction are 14.00 for peanut, 15 for milk and 7 for egg. So a class 4 egg has a high risk reaction but milk and egg are class 5. My son's lab report has the class number by each of these.

I've been confused talking with people before and reading on other message boards when people use all these different classes/measurements. Please make sure you understand which measurement system your doctor is using. One of our allergists will not challenge test an individual until they test result is 2. What 2? Class 2? 2 kU/L? 2 on the skin prick test? Make sure you understand the units!!!

And the very bottom line is that the skin prick test and RAST cannot be relied on completely for determining if your child is safe or unsafe for certain foods. We found out about his food allergies after rushing him to the emergency room at 7 months. Turned out he was allergic to milk and egg (skin prick test). The SPT results correspond with the reaction. Peanut/nuts were very low at the time of that test. No RAST was done at the time. So, is he allergic to milk now? The last time he had milk (formula) he was (7 months old). Now he's going to be 3 in 2 weeks. He was skin prick tested when he had these RAST done (August) and was a 4 on milk (it was irregular shaped, not as big), 4 on egg and 4+ on nut. (Size/shape not millimeter measurement).

The only true test is a challenge and I don't plan to use that test on my son until he is over 5 and the skin prick test and RAST test both indicate very, very low.

[This message has been edited by tnmg (edited October 06, 2006).]

[This message has been edited by tnmg (edited October 06, 2006).]

[This message has been edited by tnmg (edited October 06, 2006).]

On Oct 6, 2006

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[This message has been edited by Flounder (edited January 08, 2007).]

On Oct 20, 2006

Bump

On May 5, 2007

Reraising for the newbies [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] HTH (hope this helps!)

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