Please help interpret test results.

Posted on: Mon, 05/15/2006 - 6:53am
anonymous's picture
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Joined: 05/28/2009 - 16:42

I received my son's Cap Rast Feia results today via a phone call from the allergist. We haven't had testing for a while so I am confused by the results. In addition, my husband got the call so it is third party.

I am not familiar with this newer Feia test either. I am quite surprised and cautiously optimistic by the results (if they are accurate).

OK, here it is...
almond- 0
cashews- 0.35
crab- 2.18
walnut- 1.19
lobster- 2.01
peanut- 3.74
shrimp- 2.02

According to what they nurse told my husband, anything over 14 indicates a risk of a serious reaction and that based on these low numbers, they may want to consider some challenges.

Can someone shed some light on these numbers or direct me to a link that will show the scale? I haven't been able to find anything to help me clarify things.

Thanks in advance.

[This message has been edited by StartingOver (edited May 15, 2006).]

Posted on: Mon, 05/15/2006 - 10:57am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

I think the reason that nobody is giving you feedback is that there are a lot of unknowns--
**I am not familiar with this acronym for the test, so I can't say whether the ImmunoCap test I am familiar with has the same scale (it runs from class 0 to 6, 0 to >100 kU/L in allergen-specific IgE). You'll need to see the sheet these results came back on. I'd ask your physician for a copy for your own records.
** In the absence of any reaction history, I'd say these don't look too bad... ummm, but then again, I have to qualify that by saying that I don't know what the linear range and error of the method are.
** Has your child had any reactions to any of these items? Reaction history trumps test results every time. Then again, if your child [i]isn't[/i] reactive, what does your allergist think that means?
** Has your child had any exposure to any of these items that you are aware of? I ask this b/c DD has historically RAST-ed low or even zero to TN, but had no exposure prior to that. We know now that she is allergic to several TN-- it just took exposure to find out. [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] Also, RAST is generally the less sensitive of the two tests... thus it tends to give false negatives... though false positives are not unheard of. The pn number is waaaaayy too high to consider a challenge, according to most of the experts in the field.
** How old is your child? Are these the first blood tests you've had done?
What exactly were you curious about?
I'd also be optimistic-- [i]if[/i] your child has had numbers which were higher, has had exposure to all of those allergens, and has not had a severe reaction. Oh-- and if they are more than about 4 years old. Until then, the numbers come and go.
[This message has been edited by Corvallis Mom (edited May 15, 2006).]

Posted on: Mon, 05/15/2006 - 10:58am
Momcat's picture
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Joined: 03/15/2005 - 09:00

FEIA stands for Fluoroenzyme Immunoassay. It is different from the original RAST which uses radioactive IgE markers. I believe the Pharmacia ImmunoCAP test that is commonly in use now is the FEIA type.
I think the scores of both types are comparable because they both work by marking the allergen specific IgE in the blood and then "counting" it by looking at the brightness of the sample. The fluorescent or radioactive enzymes attach themselves to the allergen specific IgE. Then a machine is used to measure the brightness of the sample. The brighter the sample, the higher the score.
It looks like Almond was negative, Cashew was Class 1, the others were Class 2 except for peanut which was Class 3. According to my allergist, Class 3 is considered "high positive", Classes 4-6 are considered "very high positive".
Class 0 <0.35 (negative)
Class 1 0.35-0.7 (low positive)
Class 2 0.7-3.5 (positive)
Class 3 3.5-17.5 (high positive)
Class 4 17.5-50 (very high positive)
Class 5 50-100 (very high positive)
Class 6 >100 (very high positive)
For which foods are considering a challenge?
Cathy
------------------
Mom to 6 1/2 yr old PA/TNA daughter and 3 yr old son who is allergic to eggs.
[This message has been edited by Momcat (edited May 15, 2006).]
[This message has been edited by Momcat (edited May 15, 2006).]

Posted on: Mon, 05/15/2006 - 11:01pm
jtolpin's picture
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Joined: 05/28/2003 - 09:00

I think those numbers look GREAT IMO.
Based on RAST scales of 0.35 to >100, those are 'LOW'.
If the child RAST - (or low positive), and a SPT shows negative, an oral challenge COULD be the next step.
For our situation, thats what would occur.
Good luck with upcoming challenges should you choose to do so!
Jason
------------------
[b]* Obsessed * [/b]

Posted on: Tue, 05/16/2006 - 9:13am
anonymous's picture
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Joined: 05/28/2009 - 16:42

While I am happy that his numbers are pretty low, I agree that ultimately his history of reactions is of more importance. I don't think this will really change anything for us.
Corvallis Mom- He has reacted to peanuts on a couple of occasions and once to almonds. It could be that the almond candy bar was cross contaminated by peanuts. He has never eaten or reacted to shellfish. I would like to say that he has never been exposed but I can't imagine that to me true.
I remember when he was about 2 or 3 he accidentally got a cashew in some turkey stuffing and immediately spit it out and said that his tongue felt funny so he has had a mild reaction to cashew.
I did have blood tests done on him a few years ago but I can't find the results right now. I am not sure if they tested for tree nuts at that time. We were focusing on finding out about shellfish and I remember her saying that the numbers were very high...so maybe there has been some improvement there. To tell you the truth, I have just always considered him to be very allergic and not focused too much on the numbers.
We have just switched doctors and they are short on office staff. That is why I haven't seen the hard copy as of yet. I am waiting for it to arrive in the mail.
Momcat- thanks for the scale. I really couldn't find one. That clarifies things for me. Peanuts are still high. I am expecting a call back to talk more about what they want to challenge but I don't think, at this point, that I am too interested in doing that. I'll have to find out more first.
Jason- I am happy to see that the numbers aren't through the roof but I don't know how this will change things for us if it will at all.
I'll keep you updated when I hear back from the doctor. Thanks for your good wishes!

Posted on: Mon, 05/15/2006 - 10:57am
Corvallis Mom's picture
Offline
Joined: 05/22/2001 - 09:00

I think the reason that nobody is giving you feedback is that there are a lot of unknowns--
**I am not familiar with this acronym for the test, so I can't say whether the ImmunoCap test I am familiar with has the same scale (it runs from class 0 to 6, 0 to >100 kU/L in allergen-specific IgE). You'll need to see the sheet these results came back on. I'd ask your physician for a copy for your own records.
** In the absence of any reaction history, I'd say these don't look too bad... ummm, but then again, I have to qualify that by saying that I don't know what the linear range and error of the method are.
** Has your child had any reactions to any of these items? Reaction history trumps test results every time. Then again, if your child [i]isn't[/i] reactive, what does your allergist think that means?
** Has your child had any exposure to any of these items that you are aware of? I ask this b/c DD has historically RAST-ed low or even zero to TN, but had no exposure prior to that. We know now that she is allergic to several TN-- it just took exposure to find out. [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] Also, RAST is generally the less sensitive of the two tests... thus it tends to give false negatives... though false positives are not unheard of. The pn number is waaaaayy too high to consider a challenge, according to most of the experts in the field.
** How old is your child? Are these the first blood tests you've had done?
What exactly were you curious about?
I'd also be optimistic-- [i]if[/i] your child has had numbers which were higher, has had exposure to all of those allergens, and has not had a severe reaction. Oh-- and if they are more than about 4 years old. Until then, the numbers come and go.
[This message has been edited by Corvallis Mom (edited May 15, 2006).]

Posted on: Mon, 05/15/2006 - 10:58am
Momcat's picture
Offline
Joined: 03/15/2005 - 09:00

FEIA stands for Fluoroenzyme Immunoassay. It is different from the original RAST which uses radioactive IgE markers. I believe the Pharmacia ImmunoCAP test that is commonly in use now is the FEIA type.
I think the scores of both types are comparable because they both work by marking the allergen specific IgE in the blood and then "counting" it by looking at the brightness of the sample. The fluorescent or radioactive enzymes attach themselves to the allergen specific IgE. Then a machine is used to measure the brightness of the sample. The brighter the sample, the higher the score.
It looks like Almond was negative, Cashew was Class 1, the others were Class 2 except for peanut which was Class 3. According to my allergist, Class 3 is considered "high positive", Classes 4-6 are considered "very high positive".
Class 0 <0.35 (negative)
Class 1 0.35-0.7 (low positive)
Class 2 0.7-3.5 (positive)
Class 3 3.5-17.5 (high positive)
Class 4 17.5-50 (very high positive)
Class 5 50-100 (very high positive)
Class 6 >100 (very high positive)
For which foods are considering a challenge?
Cathy
------------------
Mom to 6 1/2 yr old PA/TNA daughter and 3 yr old son who is allergic to eggs.
[This message has been edited by Momcat (edited May 15, 2006).]
[This message has been edited by Momcat (edited May 15, 2006).]

Posted on: Mon, 05/15/2006 - 11:01pm
jtolpin's picture
Offline
Joined: 05/28/2003 - 09:00

I think those numbers look GREAT IMO.
Based on RAST scales of 0.35 to >100, those are 'LOW'.
If the child RAST - (or low positive), and a SPT shows negative, an oral challenge COULD be the next step.
For our situation, thats what would occur.
Good luck with upcoming challenges should you choose to do so!
Jason
------------------
[b]* Obsessed * [/b]

Posted on: Tue, 05/16/2006 - 9:13am
anonymous's picture
Offline
Joined: 05/28/2009 - 16:42

While I am happy that his numbers are pretty low, I agree that ultimately his history of reactions is of more importance. I don't think this will really change anything for us.
Corvallis Mom- He has reacted to peanuts on a couple of occasions and once to almonds. It could be that the almond candy bar was cross contaminated by peanuts. He has never eaten or reacted to shellfish. I would like to say that he has never been exposed but I can't imagine that to me true.
I remember when he was about 2 or 3 he accidentally got a cashew in some turkey stuffing and immediately spit it out and said that his tongue felt funny so he has had a mild reaction to cashew.
I did have blood tests done on him a few years ago but I can't find the results right now. I am not sure if they tested for tree nuts at that time. We were focusing on finding out about shellfish and I remember her saying that the numbers were very high...so maybe there has been some improvement there. To tell you the truth, I have just always considered him to be very allergic and not focused too much on the numbers.
We have just switched doctors and they are short on office staff. That is why I haven't seen the hard copy as of yet. I am waiting for it to arrive in the mail.
Momcat- thanks for the scale. I really couldn't find one. That clarifies things for me. Peanuts are still high. I am expecting a call back to talk more about what they want to challenge but I don't think, at this point, that I am too interested in doing that. I'll have to find out more first.
Jason- I am happy to see that the numbers aren't through the roof but I don't know how this will change things for us if it will at all.
I'll keep you updated when I hear back from the doctor. Thanks for your good wishes!

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