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I have a question for you all.

My son has a severe pa, tna, and salmon. He is also testing positive to milk and egg. He has had anaphalaxis to peanuts and salmon, but is non-reactive to milk and egg when accidentally exposed. His allergist is clear that she doesn't want him to have any milk and egg and thinks he will outgrow the allergy if he isn't exposed.

My question is this: if he is non-reactive to milk and egg, would any of you request the allergy be challenged?

I am not comfortable with the skin prick and RAST being 100% accuruate. For instance, his salmon allergy is a 2 (he had an anaphalactic reaction this summer) and milk is a 19!

I'd appreciate any advice, I'm new here!

Thanks!!

On Dec 30, 2005

My son skin tested positive to foods he normally eats like tomatoes and milk.

Other positives he had that he avoids are of course peanuts, soy, oats, fish and tree nuts.

The uber allergist we recently saw said that is you skin test positive you can still eat the food if it does not bother you.

Now I do not subscribe to this myself. The original allergist told us any allergy can become anaphylactic over night.

But my son can eat tomatoes and a just a bit of milk. He'll get GI symptoms from the milk.

How do you find out which one you CAN eat? Challenges sound good but a bit scary. I suppose in a well prepared allergist office you'd be OK and it might be worth a try.

Peg

On Dec 31, 2005

Thank you Peg541 for the information. It definitely makes me want to ask the allergist to challenge the milk and egg allergy. I would want them to challenge him in their presence, just in case.

It is all so confusing since the tests arent' always accurate. When my son had his first RAST test it came back positive for oat, soy, wheat, which he was never allergic to. That's why I question things.

On Dec 31, 2005

I don't know how long you've been dealing with this, but when do you want to challenge? Are you wanting to wait a while or challenge now? If now, why now? Has it been a few years since the last exposure?

There are folks on the board whose kids have outgrown their other FAs and who I think would encourage you to avoid exposure to help ensure your child might outgrow the other FAs. I could be wrong.

And I have to say that my son has a slight allergy to soy and to pecans but we don't avoid them. We minimize them, but frankly, he delights in the fact that he can have pecans we shell on special occasions.

But it's not milk and egg that I'm dealing with. Those are definitely worth outgrowing, and because my tiny pecan allergy has been with me all my life, I'm not likely to think that DS' will go away (but it's not life threatening).

But the milk and egg allergies going away are worth investing some time away from, in my opinion. I don't see the need for a challenge--but maybe you could get another test. Maybe your results weren't right. I've heard of false positives--even from my doctor--with the CapRast test. My doctor likes the ImmunoCap and thinks it's more accurate.

[This message has been edited by McCobbre (edited December 31, 2005).]

On Dec 31, 2005

Those darn test are indeed not always accurate, but you could simply not feed your son those foods as your allergist advises, and then retest him in a year or so to see if the results have improved?.

There are so many conflicting results and reactions out there..enough of them to come to the conclusion FOR MY FAMILY, that we will just not eat those things dd and ds are allergic to , to avoid may contains and manufactured on...as well. My kids are small enough for me to hope that if I practice strict avoidance with them, it will not only keep them safe from a very serious reaction, but teach them to 'not' eat those foods they're allergic to and will maaaaaybeeee help them outgrow those allergies. But that is just what work for me!

On Jan 1, 2006

I appreciate everyone's advice, it really helps.

The reason for why I want to challenge is because of the simple reason that when accidentally exposed (preschool gave him rainbow goldfish without my permission) and he had absolutely no reaction. As a matter of fact, I didn't know about the snack until a week later when ds told me he ate it and had no reaction. There have also been a couple other exposures with no allergic response.

Is it possible that the milk or egg could be part of the "bucket or glass" effect where when it fills that is when he will have a reaction? I thought when you have an allergy to something, your body immediately or within a couple hours responds to the allergen???

On Jan 1, 2006

I'm sorry, nothing to do with the original question - I have to ask- what is an "uber" allergist? Like the best of the best? [img]http://uumor.pair.com/nutalle2/peanutallergy/redface.gif[/img]

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

------------------ "That was Polanski. Nicholson got his nose cut."

On Jan 1, 2006

I was told that dd was also allergic to wheat, egg, soy, tomatoe -I told the allergist that she eats all these things, so he did little food challenge in his office and sure enough she was fine.

She is allergic to pn, tn and sesame- also slightly positive to sunflower seeds-

I keep her away from all seeds to be safe-

I guess my advice would be, if he has eaten milk and egg without a problem, I might do a food challenge of these things in the office- it would make your life a little easier-

Has he eaten these things or just the little bit of goldfish?

On Jan 1, 2006

How old is your son?

My answer depends on your question. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Amy

On Jan 2, 2006

Ryan was positive confirmed for peanuts via skin test at age 3 (he had known anaphylactic reactions to peanuts). At 4 he had a blood test for peanuts only just to see what his levels were. At 6 I insisted on the big 4 tree nuts just to see where we stood on them. He had eaten plenty of pecans, almonds, walnuts, and cashews from 18 mos. to 3 years with absolutely no problems. Cashews were eaten for lunch virtually every day from 2 1/2 to age 3.

His peanut RAST was >100, then 67 or something like that. His tree nuts were .35 (pecan), .99, 1.24, and 1.54 (cashew). Very low with no reactions as opposed to peanut with known reactions and very high scores.

Our allergist was resistant to testing him for tree nuts because scientific testing is by no means conclusive. He said actual medical history is the best predictor for a course of action (not exact wording). We have avoided tree nuts since age 3 because of possible cross contamination with peanut. When he is older, maybe 14 or 15, perhaps we will revisit the tree nuts IF we could find a safe supplier AND with an oral challenge in the office with such a long lapse of time since eating tree nuts.

Ryan has never been tested for anything other than peanuts (doctor's and my insistence on RAST), and the 4 major tree nuts (at my insistence only). He prefers testing not be done if Ryan has been successfully eating consuming foods without any problems. He is now over 9 years old.

His "exact" wording with reference to testing of other consumable allergens was, "What is that going to prove?" In his own practice, he sees quite a few patients test highly positive on blood tests, and yet can eat/drink the allergen in question with no problems.

This is just our own experience and perspective on things. Of course, you must do what you feel is right with respect to managing food allergies and your doctor's/allergist's recommended course of action.

On Jan 2, 2006

I would not judge an allergy based on a few small single exposures. Not much milk in a goldfisk cracker. My dd ate PB for a couple of months, frequently, *then* developed obvious reactions. And it was a sudden increase. I had wondered if she had a problem, but it was hard to tell if she was just messy and putting PB in her eyes. Then one day, a single bite, and BAM! Still working it in her mouth and her eyes were watering, cheeks flushed, nasal congestion. Her cheeks were crusty for several days following. And we were very lucky. I just cleaned her up and she was fine within 30 minutes.

Any allergy could be this way. I am terrified to ever even trust a food challenge because of this reaction hsitory with her. Definately a great example of "filling the glass" theory. becca

On Jan 2, 2006

Becca, that's a good point.

On that same note, if Ryan were diagnosed early on (and he showed PA symptoms from the moment he was born), perhaps we would have thought his PA was "not that severe". Many people that I've met have children that were diagnosed early on (around 12 mos)--but basically with hives. Ryan had rashes and eczema from day 1, but didn't have anaphylactic reactions until over 2 1/2 from peanut. Up to that point he drooled, spit, coughed, etc., but we didn't put two and two together--coupled with lack of knowledge of food allergies.

Since he went so long undiagnosed to peanut with consistent, repeated exposures, his glass was filling up. Then he started experiencing terrible reactions simply by biting into, but not eating a Reese's piece on two occasions. That's when we clued in on peanut, but still weren't aware how deadly a PA was. A couple weeks later at his 3-year checkup, we were given a referral to an allergist. Our pediatrician was skeptical about a peanut allergy, probably because he had gone so long without being diagnosed. (Hmmm...you would think asthma and severe eczema should have been a tip-off for an MD but that's another issue altogether.) But once she heard about our two incidences, she promptly wrote up that referral along with an epipen prescription.

Which brings another point up. If a child is diagnosed early on with only hives, is that why parents give me the "not that severe" lecture for their child? Because if Ryan were diagnosed early on, perhaps I would be giving that same speech. I don't know. But it is a point to ponder. Does the glass filling up mean anything in medical terms? Does it predispose one to anaphylactic reactions more so than another whose glass has not filled up?

So many questions, so few, concrete answers.

On Jan 2, 2006

In answer to your question Going Nuts, my son is 4 years old and has been diagnosed with all his food allergies since he was 18 months.

There were several other foods that the RAST showed were positive but we were able to rule out with the skin prick. His last allergist had me challenge the soy on my own at home and we were successful with no allergy.

Its a hard call because I do want him to outgrow his milk/egg allergy if he is allergic, but if he is truly not allergic, it would make like SO MUCH EASIER.

On Jan 2, 2006

My son Dustin is 2 and at 11 months had an allergic reaction (vomiting, severe hives and facial swelling) after eating a few bites of peanut butter for the first time. His allergist told me that his first exposure to peanuts was in my breast milk because I ate peanut butter while nursing him. He has not experienced another reaction since his first and his recent RAST test was 28 (still in the very high range). The doctor told me that the more times that a child is exposed to the allergen, the more antibodies are produced in the body; therefore, every subsequent reaction will more severe than the last. The body builds it's defenses up and eventually an overreaction occurs (ie. anaphylaxis). Only 20% of PA outgrow their allergy. Seventy percent of young children with FA and eczema will develop asthma. My son also has allegies to eggs and has eczema. He is able to eat foods with eggs in them without trouble, but he will not eat straight eggs (maybe he knows more than I do). Once I gave him a bite of fried eggs and the vomited. He has refused to eat them since then. I think that this full glass theory has to do with the higher levels of antibodies.

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