skin testing

Posted on: Fri, 05/10/2002 - 9:17pm
LI-LIAN's picture
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Joined: 05/11/2002 - 09:00

pMy daughter has been diagnosed with a peanut allergy. She had a reaction when she shared her brother's (not pa)peanut butter sandwich at 10 months of age. She was then confirmed to have the allergy when she was skin tested at 15 months. They did the test on her forearm (a huge number of allergens seemed to be tested) and she showed up a 8X6mm weal with the peanut allergen. I was not offered a RAST or CAPRAST test for her (perhaps she's too young?). Reading the literature on the net and the discussion questions on this site has led me to question the accuracy of the test for future reference ie if she gets tested again and the weal is smaller or the same, does it mean anything? I may ask her allergist about the CAPRAST when I next see him (probably in a year's time to test her again) - am praying real hard that she is one of the 20% that outgrows it./p

Posted on: Sat, 05/11/2002 - 1:39am
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Joined: 12/18/2001 - 09:00

Welcome to the boards Li-Lian!!
Actually my daughter was RAST tested when she was 12 months, so she probably is not too young. I am also hoping my dd is one of the 20% who outgrow but we are living as if she will never outgrow because it is such a small chance. They are now even finding that some kids thought to have outgrown are having problems with the allergy reoccurring later in life. Not to be the bearer of bad news but just to let you know. Now this is only my opinion but I will not have my dd scratch tested again for quite a long time. I plan on having her CAP RAST tested yearly to keep an eye on her numbers but the scratch test is out. The reason why is that is considered an exposure and they say the key to outgrowing is absolutely no exposure at all for a couple of years. Maybe if she has a few years of negative RAST scores and they want to do a scratch test before a food challenge I would allow that but that is the only way. As far as your question of if she does get scratch tested and the wheals get smaller, the one thing I keep reading about this allergy is it's unpredictability! So the next reaction may be smaller but it really doesn't mean much. Just keep those hopes up! This board has helped me more than anything else! It keeps you informed and lets you know you have people who understand all your frustrations! We're all here for each other! Take care! [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]
kcmom

Posted on: Sat, 05/11/2002 - 6:30pm
LI-LIAN's picture
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thanks for the info kcmom and encouragement that came with it. I'm heading off to singapore in June and face it with fear and trepidation knowing full well that there will be countless opportunities where she will be exposed. sigh. we're heading back for my grand-dad's big 84th birthday and with the lack of knowledge about potentially fatal allergies in asia, it's hard to explain it to well-meaning friends and relatives. take my mother-in-law who thinks that it's just a rash producing allergy so it doesn't matter that the soup contains peanuts, you can just drink the soup and not eat the peanuts...I can't get the message across and can't hope to...I will ask the allergist about RAST and CAPRAST testing (by the way, we live in Ozzieland) - he may not have offered it to us because it was a first consultation and already the fee was $200 so I cannot imagine what it would've cost us if he had included the blood test. I will be regularly reading replies in this discussion board. It's lovely to know that I'm not just a paranoid mother and that there are lots of mums all over the world going through the same angst.

Posted on: Sun, 05/12/2002 - 4:05am
smack's picture
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Joined: 11/14/2001 - 09:00

LI-LIAN,
Hi, just wanted to let you know if you have an allergist that believes not to Rast or Cap Rast till (I believe 2 or 3?) that's because some don't believe the blood tests are
accurate until then.
Some that do go through with such tests may have false positives.

Posted on: Sun, 05/12/2002 - 5:23am
momjd's picture
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Joined: 02/24/2002 - 09:00

Unfortunately, skin testing can be inaccurate for children under the age of 2 as well- particularly those with eczema. Both tests improve considerably when combined with your observations and a good case history. As I understand it, many allergist simply don't believe in RAST testing which is dependent upon the skill of the lab analysing the results. Skin testing is accurate in *most* patients and is less costly so is often the test of choice. A CAP RAST (must be CAP brand) is said to be more accurate than the RAST with regard to peanut, egg and some other foods. If you want a baseline measure for future comparisons, the CAP is probably the way to go. BUT, you'll need to do your research and be able to talk to your doctor with real facts and figures or he or she may not take you seriously. It's been my experience that telling them that "someone online" told you about a test isn't as effective as saying "I read in Dr. Wood's book that...". The Peanut Allergy Answer Book is a hand guide for PA; for multiple food allergies and a good overall analysis of the science involved J. Brostoff's Food Allergies and Food Intolerances is pretty helpful. Also, there is a link in the research section here to an article title "Where We Stand"- it summarizes almost every major PA study done in recent years. After you've read that study you'll have some idea regarding just how up to date your own doctor is.

Posted on: Thu, 01/30/2003 - 2:06pm
cynde's picture
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Joined: 12/10/2002 - 09:00

I personally would re-schedule, or could they do a blood test?
Have fun at Disney (like it's possible not to). [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]
------------------
Cynde

Posted on: Wed, 09/24/2008 - 11:43pm
mom0810's picture
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Joined: 03/30/2007 - 09:00

anyone?

Posted on: Thu, 09/25/2008 - 1:02am
pfmom2's picture
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Joined: 01/22/2006 - 09:00

For my child who has anaphylaxis to contact, I would not do skin testing. I have read too many stories where someone has needed Epipen after skin testing.
You have to do what you feel is right for you. If your rasts have always been zero, then why the reactions? What I mean is maybe the rast is a false negative. Go with your gut on how you feel, don't be forced into something you are not comfortable doing.
Best of luck with your decision.

Posted on: Thu, 09/25/2008 - 1:51am
mom0810's picture
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Joined: 03/30/2007 - 09:00

I have heard of false positives with RAST, but not false negatives.
The reason I am even considering the skin test is the anxiety I feel all the time regarding accidental exposure. I know this is something all pa p-eople and parents have to deal with, but if I am doing it for no reason, it would be good to know. If my rast and skin test are both negative, he says I have a 99% chance of no allergy. It would be good to know if it is, in fact, gone since I only had issues while pregnant/breastfeeding that child.

Posted on: Thu, 09/25/2008 - 2:01am
pfmom2's picture
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Joined: 01/22/2006 - 09:00

With my youngest child, the Rast has been negative to all things and then skin test is done and we get some positives. My second child has allergies, not to the extent of my first, however, Rast is negative to things and then we get positives with the Skin Testing. I know there are allergies because of the symptoms. I always figured that the Rast can have false negatives.
I understand what you are saying though that you want to know. At least you know that you are in the right place should you have a reaction with skin testing.
Best of luck. Let us know how it goes.

Posted on: Thu, 09/25/2008 - 2:14am
MommyOfTwo's picture
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Joined: 11/08/2007 - 09:44

I had my DS SPT when he was 4 months old then again at 16 months. He didn't have a RAST done at 4 months so I can't compare the numbers to his RAST at 16 months. At 16 months his RAST is barely over the positive mark at .40. His SPT results though are much higher.
At 4 months his SPT wheal for pn was 9mm and at 16 months it was 10.5mm. Personally he never had any issue with either SPT. He was of course a little itchy but after being cleaned up and I gave him some benedryl (also since he was off his Zyrtec and benedryl for a few days leading up to the SPT) he was fine. I won't be doing anymore SPT though unless he falls below the negative level and I certainly will NOT do a food challenge unless he were to have a negative SPT.
You have to do what you are comfortable doing and certainly don't let anyone pressure you into anything. If your RAST came back negative I would certainly say the SPT would be the next step. If feel comfortable from that you can then decide to do the food challenge. Take it in baby steps and do what you feel comfortable with. Keep us posted on what you decide and how it goes! :-)

Posted on: Thu, 09/25/2008 - 2:20am
mom0810's picture
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Joined: 03/30/2007 - 09:00

Thank you both so much for the info. I am just really scared and don't know if I will even do it. With my RAST showing nothing, I feel a bit more confident, but still, I have no known exposures since the PB sandwich for my hubby and that was 2 years ago.
What prompted my thinking of going is two incidents recently where I could have been exposed and they scred the heck out of me. One was at the store and the other was at a doctor's (Doctor's!) office where the receptionist was eating peanuts and handing stuff to me. I was scared to death to touch that stuff.
So, I figured rather than dwelling on all of this for the rest of my life, I should go and confirm. Allergy or none. And move on with my life.

Posted on: Thu, 09/25/2008 - 4:35am
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Joined: 06/06/2007 - 09:00

I would do the skin test if I were you. If your rast was negative, a negative spt might put you at ease. The only thing is that the only way to prove that you are not allergic is to do a food challenge (in the proper setting of course with dr. approval). My ds had a borderline + SPT for shrimp at 3 years old and then at his 4 year old visit the SPT was negative. My allergist still considers him as allergic until we do a food challenge. Good Luck and try not to stress to much. I know that is easier said than done :-)

Posted on: Thu, 09/25/2008 - 9:30am
mom0810's picture
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Joined: 03/30/2007 - 09:00

I think if I do the skin test and it's negative, I might stop there. He told me that even with a negative rast not to worry to much but the spt would put me at ease a little more.

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