Skin test negative??? and rant.

Posted on: Thu, 01/04/2007 - 6:08am
anonymous's picture
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Joined: 05/28/2009 - 16:42

Once again I am full of questions, DS had a skin test done yesterday and I am a little confused by the results. I go in next Thurs. to discuss them with the Allergist but that is still a week away. All the foods DS tested for are foods that he tested + for in Blood test ~1 yr ago (6months old) except sesame and tree nuts. Sesame we discovered from very obvious and immediate reaction about 4 months ago.
DS has sensitive skin and occasional excema outbreaks and everything tested for had some redness and swelling, including the control -. Obvious +'s were wheat and egg, which I never doubted from DS's recent exposures to. The nurse who did the test told me sesame was -, I told him I was very surprised by that since we had a relativly recent reaction and he decided to mark it as a small + [img]http://uumor.pair.com/nutalle2/peanutallergy/confused.gif[/img] . Also milk came out -. I know he is contact allergic. We have had 2 known incidents in the last 5 months where DS got milk/butter on arm and broke out in hives and several cases where I suspect milk. And with our Pediatricians advice we tried giving him milk 6 months ago and he had obvious although not severe reaction. Other negatives to food were peanut, treenut and soy. I don't doubt the soy since DS has never had reaction to when ingested. He's never had peanut or treenut.
These are some of the questions I have: How accurate can the test really be if he reacts to the control -? What do you think of the nurse changing sesame to a small +? I remember reading something about how you can test - if you haven't had recent exposure and still be allergic but I thought this was blood test. Does anyone know more about this? Can you have a - and still be allergic?
I pulled the following off another thread.
[url="http://pediatrics.aappublications.org/cgi/content/full/111/6/S2/1638#SEC5"]http://pediatrics.aappublications.org/cgi/content/full/111/6/S2/1638#SEC...
"In children younger than 1 to 1.5 years, the negative predictive accuracy of the skin test is lower, probably 80% to 85%, because cutaneous mast cell numbers and the degree of sensitization may be too low to detect a response in the skin."
On the same thread I read of someone reacting after a - skin test and I found this while looking elsewhere.
[url="http://www.aaaai.org/patients/publicedmat/tips/foodallergy.stm"]http://www.aaaai.org/patients/publicedmat/tips/foodallergy.stm[/url]
"It is uncommon for someone with a negative skin test to have an IgE-mediated food allergy."
So while it's uncommon it still happens on occasion?
My DS is almost 16 months. So really how accurate was this test?
Overall I'm left wondering why the test was even done since my DS has mild excema, is under 18 months, has a recent history of reactions to most of these, and even the +'s are only 50% likely to be correct. I wish I had known more before testing. I'm afraid I'll go in and the allergist will tell me the test was pointless.
We are not happy with allergist or with our pediatrician, at least when it comes to allergies, but plan on moving soon and would like some sort of answers and advice specific to our situation and DH and I are unwilling to wait indefinatly to find another Allergist.
On a side note DS had runny nose before going in yesterday and he spent all night wheezing and coughing. I don't know if it was from a cold or from the test. I gave him benadryl before bed because he still had welts all over his back and a couple of bumps on his legs that I'm not sure were related but didn't want to take a chance. Needless to say, I didn't sleep well I'm exhausted today.
If your still reading thanks for listening to me rant. I think I included everything pertinent. Any thoughts?

Posted on: Thu, 01/04/2007 - 6:38am
Lori Jo's picture
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Joined: 09/17/2003 - 09:00

Well, we haven't done skin testing for our PA dd, but the only allergy we are aware of so far is her PA. I was reading your post wondering if you maybe shouldn't find a different allergist, before I got to the bottom of the post. I would say make sure you have an allergist who deal alot with children, like maybe one associated with a children's hospital, etc. Or try posting on the board about where you are and asking if there are any recommended allergists around there. It seems from what I've read here that many members have had a wide variety of allergist experiences. It can be frustrating. I would also say, ask all those same questions to the doctor when you go next week. It will keep him on his toes, and if you don't like his answers, it will give you more fuel to the fire to find a different doc. Or maybe he'll have good answers, and make you feel better about the whole thing.
Either way, good luck.
------------------
Lori Jo,
Rose, 7-31-02, PA
Beatrice & Georgia, 8-14-99

Posted on: Thu, 01/04/2007 - 1:02pm
Momcat's picture
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Joined: 03/15/2005 - 09:00

Some people with sensitive skin will get a welt just from being pricked (the neg. control) If this happens, it's pretty hard to tell which welts are from an allergic reaction and which are just from being pricked. Sometimes they try to compare the size, but it sounds like the results are not really valid.
Another possibility is that the test tray was accidentally contaminated before the nurse pricked your son. They try to be careful, but sometimes the extracts drip and they don't notice. I think doing a good skin test is a bit of an art, and not all nurses are equal if you know what I mean...
Cathy
------------------
Mom to 7 yr old PA/TNA daughter and 4 yr old son who is allergic to eggs.

Posted on: Fri, 01/05/2007 - 12:54am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

I can also tell you that it IS possible to have a negative skin test and be allergic. DD SPT's negative to milk. But she definitely reacts with very predictable symptoms (puffy, itchy lips and hives/eczema around her nose and mouth) -- but it is a much more hit-and-miss kind of thing, to be honest... not at all like her life-threatening food allergies.
It is also possible that incubating a viral illness made him more sensitive.... but I don't know if it can make them [i]less[/i] so...
I also agree with MomCat about the - control invalidating the rest of the results. They need to find a place to test where the skin is less sensitive (arms are better on some kids for that reason).
You need to see an ALLERGIST for a discussion of SPT results, too, JMO. Our allergist has two awesome nurses, one of whom does all the SPT for the office, but nobody but the doctor evaluates and talks to you about results. Not with my MFA kid, anyway.
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Fri, 01/05/2007 - 4:47pm
NicoleinNH's picture
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Joined: 06/21/2003 - 09:00

***
[This message has been edited by NicoleinNH (edited June 10, 2007).]

Posted on: Fri, 01/05/2007 - 10:55pm
momll70's picture
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Joined: 09/26/2006 - 09:00

I'm confused about tests also. My test for peanut shows low reaction to the point where I feel my allergist doesn't think it's bad. When I accidentally ingested trace amounts I felt like I was choking on sand. I think that's bad. And it keeps getting worse with each exposure.

Posted on: Sat, 01/06/2007 - 5:13am
anonymous's picture
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Joined: 05/28/2009 - 16:42

Thanks for all the imput. Unless this next appointment goes REALLY well we will be looking for another Allergist.
To answer some questions. The nurse did the skin pricks and measured them. He told what each one was (mostly because I kept asking) and whether it was + or -. He also explained that because the control - had a wheal that he was just comparing the rest to it. We didn't see the allergist at all.
NicoleinNH you said that the Allergist always interprets for you child, does that go for everyone else as well? I want to make sure I have solid reasons for dumping this allergist and not feeling like the dreaded over-reacting mom.
I will definately post what ever he says next week.

Posted on: Sat, 01/06/2007 - 6:00am
Momcat's picture
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Joined: 03/15/2005 - 09:00

Our allergist has his nurse perform the test and write down the measurements. However, the allergist interprets the results and discusses them with me. He makes recommendations about what to avoid, etc.
I don't think the nurse should be the one to interpret the results. Especially if you never get to see the doctor afterward to ask questions.
Cathy
------------------
Mom to 7 yr old PA/TNA daughter and 4 yr old son who is allergic to eggs.

Posted on: Sat, 01/06/2007 - 6:07am
solarflare's picture
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Joined: 02/07/2002 - 09:00

An important thing to remember is that allergy tests are falliable, and a reaction always trumps a test result.
------------------
Cheryl, mom to Jason (9 MFA including peanuts, tree nuts, shellfish and egg)
Joey (7 NKA)
Allison (4 milk allergic, suspect shellfish, avoiding PN/TN for now)
Ryan (1) nka *knock on wood*

Posted on: Sat, 01/06/2007 - 7:08am
NicoleinNH's picture
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Joined: 06/21/2003 - 09:00

****
[This message has been edited by NicoleinNH (edited June 10, 2007).]

Posted on: Thu, 01/11/2007 - 8:55am
anonymous's picture
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Joined: 05/28/2009 - 16:42

Just back from the Allergist. His first words after hellos, "I've never personally seen anyone with wheat allergies this high." Yes, I'm not crazy. Long story short I feel like he takes me seriously now, questions were answered, and he told me to avoid the milk even though. The one thing I was wrong on is Peanut is still "quite high." It was night and day from our first appointment.
Thanks for the support everyone.
~Jessie

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