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Posted on: Tue, 09/12/2006 - 4:22am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

Quote:Originally posted by Sharonagain:
[b]My son (14 months) is allergic to peanuts. We don't know HOW allergic. He ate peanut butter 3 times and each time he had a rash/hives around his mouth. These hives didn't bother him and they went away within 45 minutes. We went to 2 allergists and they said he was PA and prescribed Epis. I wanted to know regarding Benadryl...I've read that you SHOULDN'T give Benadryl because the medicine could mask the symptoms and you wouldn't know how severe the reaction is? Any suggestions?
We were told the same thing, but I think it really depends on the child. I personally would not give my dd age 11 antihistamine if I think she is having an allergic reaction. There are some on this board who do.
About the hive/hives, I always look at the timing. One morning dd woke up covered with hives, but she had not eaten in over 12 hours. I assumed it was not an allergic reaction, did not epi, took her to the allergist and he agreed. He did a blood test which proved it was not an allergic reaction. On another occasion, she developed one hive while eating. I had her stop eating, checked her carefully, no other symptoms, did not treat. I figured it was an allergic reaction due to the timing, and it turned out I was right. It was shared equipment, the manufacturer had lied to me when I called before giving the food. Anyhow, I chose not to epi for one hive, even though I figured it was an allergic reaction. Allergist agreed with this also. I think you really have to look at the timing of the hives in order to decide if it is an allergic reaction to food or not.
When she had the one hive, I would not have used antihistamine because the hive can go away while the other symptoms of anaphylaxis are developing. I personally would do epi or nothing---our instructions from the allergist are the antihistamine is to be used after epi, not in place of.

Posted on: Tue, 09/12/2006 - 6:21am
ceross's picture
Joined: 01/27/2004 - 09:00

Quote:Originally posted by Carefulmom:
I personally would do epi or nothing---our instructions from the allergist are the antihistamine is to be used after epi, not in place of.
We have the same instructions from our allergist. We are to administer Epi if there has been a suspected injection, then Benedryl, and call 911. If there is no suspected ingestion, then we can administer Epi and watch for additional symptoms before administering the Epi. DD often has contact reactions (at the mall, for example) for which the hives are localized and for which I administer only Benedryl. However, when she had an anaphylactic reaction, her hives were diffuse (and present on her torso which they are not for contact reactions), she had edema, and coughing.

Posted on: Tue, 09/12/2006 - 1:42pm
anonymous's picture
Joined: 05/28/2009 - 16:42

Carefulmom, what kind of blood test can they do to determine if it's an allergic reaction? Do they look if your total IgE is elevated? This seems like good info. to have if we ever end up at the ER uncertain whether it was an allergic reaction. I'm also thinking back to Mistey's situation with her son where they didn't know what was causing such severe symptoms.

Posted on: Wed, 09/13/2006 - 2:22am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

It was two blood tests. I think one was tryptase. I don`t remember the name of the other one. They are reactants in the blood that go up during an allergic reaction. They only stay up for a few hours (can`t remember exactly how long, but you have to have the blood drawn pretty quickly).

Posted on: Wed, 09/13/2006 - 4:48am
Corvallis Mom's picture
Joined: 05/22/2001 - 09:00

I have been thinking about this since that other thread as well... I know that one is "serum Beta-Tryptase" (which is notoriously unreliable [i]on its own[/i] for food-induced anaphylaxis...)
the other one, though.... might be serum Histamine?
Histamine may only be elevated for a period of minutes, which is why it can only very rarely be used to establish COD in autopsies. So that might be it. They pretty much have to draw it [i]during[/i] a reaction.
I'm trying to think what other analytical targets there are in that chemical cascade... Hmmm.

Posted on: Wed, 09/13/2006 - 5:24am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

I am not sure the other one was beta tryptase. Is there just a regular tryptase? Whatever it was, it stays up for a few hours after a reaction and does not have to be drawn during a reaction. It was two different things, and they must be fairly unusual tests, since we had to go 5 miles away to the hospital to have it drawn.

Posted on: Wed, 09/13/2006 - 12:55pm
Kathryn's picture
Joined: 02/17/1999 - 09:00

We have two plans--one for home when we might not give epi immediately for limited symptoms. However, we are rethinking that approach for three reasons: 1. immunologist says research/medical evidence shows that best survival comes from epi within first 5 minutes 2. evidence that epi is not harmful and does not have ill effects 3. what message does it send to our son whom we want to encourage to use epi without hesitation--better to walk the talk and use the pen--immunologist and family doctor concur and suggest that only harm can come from waiting and nothing is lost by administering
FOR THE SCHOOL THOUGH --our plan has always said that we expect epi to be used whenever it might be needed--if they are thinking about whether to do it then they must do it--there is no harm to our son if they use it and consequences of not using it can be catastrophic

Posted on: Mon, 09/11/2006 - 11:18am
mharasym's picture
Joined: 04/20/2001 - 09:00

Our doctor says Epipen for any suspected allergic reaction. He doesn't say wait for x number of hives, or 2 of 3 symptoms or only if trouble breathing or anything else. If you think he's having a reaction - give him the Epi and call 911. Done. Don't use Benedryl, don't wait and see.
Now, that all being said, we've never been in a situation where we "thought" he was having a reaction. Since he was diagnosed (age 18 months) he has never had a single symptom of a reaction to peanuts - that despite having a 100+ CAP RAST result!
So, all I can say is, if we would see him react, we would Epi and 911 and those are the instructions on his plan at school.

Posted on: Mon, 09/11/2006 - 11:25am
3xy1PAinNH's picture
Joined: 08/07/2006 - 09:00

I think we have to be careful with this one, as there are many degrees of reaction to PA. I would, in your situation, NOT give epi first. Obviously, the other poster above me has a child with an extraordinarily high RAST. The ODDS of a severe reaction are basically 100% with that sort of number.
My son had a reaction at 18 months. Benadryl worked. The said to benadryl every 4-6 hours for the next five days (YES, WAKE HIM UP to dose him!).
THe allergist did the RAST and gave us an action plan (something I thought all schools legally had to have from a DR.). It says for mild symtoms like hives, benadryl. If there is wheezing or breathing difficulty, then Epi. It is veyr clear...if you see xyz, do this dose of benadryl, if you see abc, give Epi and call 911.
Hope this helps!

Posted on: Mon, 09/11/2006 - 12:39pm
mommamia8's picture
Joined: 11/13/2005 - 09:00

Hmmm. Our allergist feels hives are major. He wants us to epi for full body hives that occur soon after ingestion, with or without other symptoms. He feels internal problems could be occurring without us knowing right away.
Btw, my son's reaction to a bite of scrambled egg caused full body hives about 7 hours later...no one can explain this odd reaction to me yet. The allergist said we could give Benedryl if THIS situation happened again.



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