Well- it appears she did NOT outgrow PA!!

Posted on: Wed, 03/27/2002 - 6:47am
ks65's picture
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sorry to report that my daughter who had been diagnosed with PA at 13 months and then did NOT have any reactions within 2 years did not outgrow PA (as far as we can tell). Her CAP RAST (the sensitive blood test) came back NEGATIVE - not even a trace of IgE for Peanuts! Her skin test came back positive. The wheal was about 5mm I think. We also tested her for shellfish/fish (CAP RAST negative and skin test negative) and tree nuts (all CAP RAST negative BUT cashews skin test psotive). The weird thing is that I had her skin tested for tomatoes, b/c on the night that she had a reaction from what we think was Pnutter, she also had a cherry tomato(raw) 5 minutes before that. WELL..she is, according to the skin test allergic to tomatoes even though she eats pasta sauce and ketchup and salsa with NO problem. Maybe it is raw tomatoes. In any event, the Peanut is so confusing b/c at 13 months she had a RAST level Class 3...now (2 years later) the CAP RAST is negative, but she seems to have a skin response. I have read and read so many articles and research and it seems that Sampson and Wood (the pediatric allergists who do alot of research) suggest that if a CAP RAST comes in below 5 (and again, hers was NEGATIVE!!!) to do the FOOD CHALLENGE and NOT do a skin test b/c it could remain positive long after the PA goes away. It just seems so hard to understand...so one part of me thinks maybe she has outgrown it, but we won't know unless we do a FOOD CHALLENGE (which the doc did not even mention or recommend) and the other part thinks that maybe she still has it and it will never be outgrown b/c now she seems to have a cashew allergy (although the CAP RAST was negative and skin test positive). Lastly, I keep reading that skin tests can give you false positives...I don't know it just seems so weird b/c we are careful, but she has been reaction free since the 1 reaction at 13 months and we do eat out and have a pretty easy going comfort zone....I think we are going to re-test at 5 years - before kindergarten - and then maybe, I would do a food challenge. Any ideas, input or advice....I just keep thinking in my heart or hearts that she is NOT allergic to the peanuts...sorry to ramble....

Posted on: Wed, 03/27/2002 - 7:00am
California Mom's picture
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I think I would handle it exactly as you suggest at the end of your post. Do the CAP RAST again just before kindergarten. If it's negative again: do the challenge. I will be keeping my fingers crossed for you!!! I agree with everything you said about the skin tests being unreliable. Also, I wouldn't do it again since it can be an exposure to the food you are avoiding. I think the chances are really, really good that your daughter has outgrown or will outgrow this nasty allergy. Good luck!!! Miriam

Posted on: Wed, 03/27/2002 - 7:12am
ks65's picture
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Thanks Miriam - when you say that you would Not do it again...do you mean the skin test...Meaning now? or in 2 years?..I guess I was thinking that your post meant to do the CAP RAST in 2 years and if NEGATIVE go right to the Challenge (skip the skin test)..Thanks for your encouragement....there just seem to be so many unanswered questions.

Posted on: Wed, 03/27/2002 - 10:15am
smack's picture
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Hi ks65,
You must be so bummed! So close then bam [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img]
Looks like a 50/50 chance though, more than a lot of people's kids here. So, with that in mind wait till she is going into school and do the test again.
Did you ask your allergist why he didn't mention a Food Challenge?
Maybe he or she has seen inaccurate Cap Rast's before and doesn't put much faith in them either.
After that Lady I talked to in POFAK whose child had a severe anaphylactic reaction THEN tested negative on the Cap Rast we have to use our heads and realize no test is 100% accurate...like the 1% of women who get pregnant on the pill?
So with that in mind, the Cap Rast was right/the scratch test was wrong.....Or the Cap Rast was wrong/the scratch test was right.

Posted on: Wed, 03/27/2002 - 12:57pm
ConcernedMom's picture
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ks65 - for what it's worth, our allergist also said that he would not do a skin test on my daughter because it can show a positive even if she had outgrown the allergy. Also, he said 60% of skin test show false positives, so maybe the skin test for tomatoes for your daughter was a false positive.
Good luck deciding what to do about a food challenge. We are in that predictament now, my daughter starts kindergarten in the fall, and we discussed a food challenge. But my daughter hasn't had a CAP RAST yet, and I'd like to do that first before I decide to do a challenge.

Posted on: Wed, 03/27/2002 - 2:17pm
ks65's picture
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ConcernedMom - definitely get a CAP RAST..that can tell you something...When was your daughter diagnosed with PA and how? (by just skin tests or reaction). Has she been reaction-free for the last few years...I would love to hear about your situation.
I think we are going to keep doing what we do until she is 5 or 5 1/2. I will then have a CAP RAST and if it is negative again...well, I will see if my doc wants to do a skin then food challlenge or maybe just a food challenge.
Good luck with your decision.

Posted on: Thu, 03/28/2002 - 6:41am
ConcernedMom's picture
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My daughter reacted to PB given to her by (at that time clueless) me at 16 months. That was almost 4 years ago, and she has not had any reaction since. Our doctor said not to get her tested until she was two because test results younger than that were not accurate. Her skin test was positive then at age 2.
I would like to get the blood test, but my daughter is freaking about her immunization shots before kindergarten, so I don't think she'll be keen on drawing blood!

Posted on: Thu, 03/28/2002 - 8:39am
Corvallis Mom's picture
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I can tell you from my husband's experiences with FA and skin tests that a great many of them show a reaction when the food itself causes NO problems... not even "subclinical" stuff that allergists usually ignore anyway. This is certainly true for my DH- who has been skin tested for the *works*... by specialists at a major medical center, so less.... anyway, skin tests for food allergens are not a very good indicator by themselves...
I was also curious about the tomato... we've been told by three doctors that little welts around the mouth from tomatoes are NOT indicative of "allergy".... just of sensitive skin. I would definitely suspect that with fresh extract in a skin test, if we had one done for tomato.... we would probably see a positive result,too... and our child is convinced that ketchup is its own food group. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Then again, the FORM of the food seems to matter a lot when it comes to moderate food allergies... DH cannot stand apple juice or cider, but tolerates apple sauce and fresh apples quite well. I tolerate orange when its cooked into something, but never OJ.
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Fri, 03/29/2002 - 8:25am
san103's picture
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I have a similar situation to yours...at 6 months my son had a positive skin test for peanuts (very minor...he also showed the same weal size for peas, which he is not allergic to) and a positive RAST (level 3). Six months later his RAST was barely positive (0.42) and at 18 months old, his RAST was negative (>0.35). Now he is 2.5 years old. We just took him to a new allergist (we moved from Oregon to Michigan). This doc would not do a skin test -- he said we should not expose him -even on a skin test. Based on his past tests, he thinks there is a chance that he has outgrown his peanut allergy...or perhaps he never was allergic (or perhaps that NAET accupressure treatment we did really worked..though the this doc does not know about it).
Good luck. I really think more kids grow out of this allergy than we think...probably b/c may allergies go unreported...I was talking to my aunt the other day and she was talking about my cousin's peanut allergy (step cousin, so not a bio-relative). I never knew this cousin was allergic...and she is now a good friend of mine (we did not know each other as kids). My aunt says they rushed her to the hospital twice when she was a teenager..both times she was having severe gasto-intestinal distress after eating peanut butter...she is now 32 and eats peanuts with no issues (but she does have other food allergies). Needless to say, I am going to have to talk to her about it...

Posted on: Sat, 04/06/2002 - 12:30am
anonymous's picture
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Congratulations on your CAP-RAST results. Please don't worry about the skin test results -- they are most likely meaningless.
Dr. Wood is my daughter's allergist. He never performs a skin test to determine if an allergy is outgrown due to the extremely high false positive rate.
With a score of zero, Dr. Wood says there is a 90-95% chance your child has outgrown the allergy. He recommends an oral challenge any time after the age of four. He said that a CAP-RAST score of zero actually means the score is less than .35 (they can only measure down to .35, so whether it's actually 0.2, 0.1, or 0.0 they cannot tell, which is why they cannot say with 100% certainty that the allergy is outgrown).
Hope this helps.

Posted on: Tue, 04/09/2002 - 7:05am
momofpeanutallergykid's picture
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I was really interested in the comments about reactions to tomatoes, oranges & apples. My DD told me that raw apples give her a sore throat (the same reaction she gets from PB), but she has no problem with apple sauce. My DH & I also got an apple from that bunch and had an irritated throat but the other apple from the basket did not bother us. I wonder how to discriminate between irritation from the acidity of a fruit VS a mild, localized allergic reaction. I might add that I tested the apple on my DD's skin, which came out positive, but then again, the acidity question. Any comments on the subject will be greatly appreciated.

Posted on: Tue, 04/09/2002 - 8:01am
Corvallis Mom's picture
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Well, if any of you are birch pollen allergic, it may be oral allergy syndrome instead (which isn't usually dangerous, just annoying as all get out). Basically, if you are allergic to birch pollen, you may have oral itching or tingling from certain foods, especially during pollen season. (apples and carrots I know are on that list...and some other fruits too) Weird that it was just the one apple, though.
We generally distinguish between what is "allergy" and what isn't by virtue of whether the symptoms are systemic/illogical or need treatment... the "welts" our DD gets from tomato sauce go away within four or five minutes of her being wiped clean... that is contact irritation, in our opinion. And she never gets them anywhere that she hasn't had ketchup or pizza sauce smeared, either.
Since its apples and since its beginning to look a lot like Claritin season, I would bet on oral allergy syndrome. (Don't usually consider apples to be really "acidic"?) Wouldn't hurt to ask your allergist about it to be on the safe side.

Posted on: Tue, 04/09/2002 - 12:56pm
san103's picture
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Last time I visited the allergist I asked about my son's reaction to tomatoes. He gets red welts around his mouth. The doctor said that a lot of allergic kids have very sensitive skin, and the food acid sometimes affects their skin. He said to keep feeding him foods if this is my son's only reaction.
Just a note...I called the pediatrician's office to get the allergist referal, and I told the nurse about the tomato reaction...she said definitely not to feed him tomatoes anymore...I am going with the allergist's opinion, not the nurse's...

Posted on: Thu, 04/11/2002 - 7:22am
momofpeanutallergykid's picture
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It is such a relief to hear that my daughter may not be allergic to apples. Thank you so much for clarifying the issue!

Posted on: Fri, 04/12/2002 - 3:10am
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I just wanted to share my PA/TNA/fish allergic son's recent experience with blood and skin testing. He is now 13, and had not had skin testing since he was 5, and had never had a blood test. When his blood tests for fish all came back negative, the doctor suggested that he may have outgrown a childhood allergy to cod. Then we did skin tests with extract, which were positive, but the doctor next had us bring in raw fish; when the fish touched my son's arm he had a reaction. For the fish that tested repeatedly negative through blood test, we may go back to do a food challenge (with cooked fish).
So in this case even though the blood test was negative (possibly due to no exposure in the past 10 years), the allergy persisted. Our doctor said that no test is foolproof and only becomes meaningful in the context of patient history, etc.
The doctor also said that there was no point in doing yearly tests, and that at 13 my son's allergies were probably predictive for adulthood.
One of the reasons we did this was that my son had begun to wonder if these food allergies were some myth that I had concocted (because he hadn't had reactions in so long), and to get lazy about the epi-pen. Our visits to the allergist reminded him of the potential seriousness of food allergy, so I highly recommend testing for a teenager either to find out if the allergies are no longer there or if he/she still needs to be watchful.

Posted on: Fri, 04/12/2002 - 4:22am
smack's picture
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Marla H,
Now that may be the most intelligent advice I have heard in a long time.
So many teenagers do die due to food allergies and I think some of them may have been prevented if they only KNEW how allergic they still are to foods that they may haven't had a reaction to in years.
Thanks for sharing your story and experience!

Posted on: Fri, 04/12/2002 - 6:22am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

I just wanted to add my support too!
I have worried about this- especially with kids who have MFA- most of the other allergies are not on the same plane as the PA, you know? Like my husband, who is soy allergic and doesn't take it too seriously... doesn't make him *feel* very good if he screws up, but it isn't life-threatening. Great advice on getting your teen to understand that there are *some* sleeping dogs that shouldn't be roused!! [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]

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