When to test Sibs for PA

Posted on: Sun, 09/07/2003 - 4:33am
ElizabethsMom's picture
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I am re-raising this topic as the last thread is dated spring 2000. Our about-to-be 3yr. old son has never been exposed to PN. Obviously, we don't know if he is allergic. What have you all done? What have your doctors recommended?

Posted on: Sun, 09/07/2003 - 1:21pm
maggie0303's picture
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Joined: 04/14/2003 - 09:00

I just recently asked our allergist regarding my almost 3 year old son. (My 9 y/o is my child with pn and other allergies.) He told me at this point no testing is needed since he doesnt have any symptoms. I have not given him nuts and he advised me not to until he is older if at all, but I just wanted to have him tested so I would know one way or the other. He told me that he could get a false positive and doesnt recommend it at this point.
I am going with what he says, and I do agree with him, but I would really like a test to tell me that this is the child I won't have to worry so much about, at least as far as allergies are concerned!
Maggie

Posted on: Sun, 09/07/2003 - 8:24pm
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Joined: 05/28/2009 - 16:42

We had our youngest (age 4) tested (blood test) this past May when Ryan went for a second CAP RAST.
Tony was never exposed to or eaten peanuts since birth (except maybe a little through breastmilk) before we found out about Ryan's PA. His CAP RAST for peanuts was negative. We will do an oral challenge during his 5th year physical next May for absolute confirmation before he goes to kindergarten. Will also blood test for tree nuts at that time since he has never consumed those either.

Posted on: Sun, 09/07/2003 - 11:38pm
MJMD's picture
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My almost 3 yr. old PA/TN DS will be having a CAPRAST done in a month or so to see if his level changed any from last year (peanut was 27 out of 100). I have a 11 1/2 month old son, who as far as we know is not allergic to anything. He has not had any dairy yet, nor egg, nor have I consumed any peanuts or tree nuts during the 3rd trimester & while breastfeeding. I took him for a CAPRAST last week (since it's a state law in DE to have a lead level screening at 1, I figured we'd do both at the same time). We are testing for milk, egg, soy & peanut. I should know the results this week. Our allergist thought this was the best route to take, because he said if he is sensitized to any of the four, it will show in the blood test. He did tell me it is a very sensitive test & it has to be done correctly in the lab or the results will be messed up. There's only one lab in DE that he trusts. Interesting enough, he wants both boys to avoid coconut & sesame as well because he said the proteins are structually very similar to peanut (PA/TN DS until he's 4, and 1 yr. old DS at least until 2 depending if he has any allergies).

Posted on: Tue, 09/09/2003 - 8:04am
Anonymous's picture
Anonymous (not verified)

Does anyone know if the tests are accurate before the child has been exposed? If so RAST or SCRATCH? I know RAST is at least influenced by recent exposure. My 3 yr old is PA. My 1yr old has only possibly been exposed while I was pregnant and first 6 mos of breastfeeding and I will not expose him because we are now peanut free. But obviously I at least need to know before he goes to preschool because I can't have a plan and epipen and convince everyone to take precautions based on his brother's allergy! He goes to the allergist to be tested next week (for milk, soy, ...+)and I don't know if the allergist will want a peanut test but (if it would be valid) I am expecting he will want a scratch test.

Posted on: Tue, 09/09/2003 - 8:29am
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only two of our 4 kids are full siblings. we found out bryce was pa as the result of a full reaction at the age of 11 mo (from a lick of peanut butter off the end of my finger). when chase was born we had her tested right before 12 mo and she too tested positive (only to an even higher degree). both incidentally were allergic to soy, wheat and egg also. they had the exact same food allergies. both continue to get more sensitive (indicated by testing) to peanuts. i'm so glad we had chase tested and didn't have to find out the way we did with bryce. it's odd enough to end up with one pa child but i was just amazed to find out both were pa. just my luck.....(or maybe i should say theirs...)

Posted on: Wed, 09/10/2003 - 1:55am
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PP quotes:
Does anyone know if the tests are accurate before the child has been exposed? If so RAST or SCRATCH? I know RAST is at least influenced by recent exposure. My 3 yr old is PA. My 1yr old has only possibly been exposed while I was pregnant and first 6 mos of breastfeeding and I will not expose him because we are now peanut free. But obviously I at least need to know before he goes to preschool because I can't have a plan and epipen and convince everyone to take precautions based on his brother's allergy! He goes to the allergist to be tested next week (for milk, soy, ...+)and I don't know if the allergist will want a peanut test but (if it would be valid) I am expecting he will want a scratch test
Caitlin was RAST for peanut, yet has never ingested them, even in utero (DW is anaph. to them and had no reactions)... I dont believe in x-contam (well, I do really, but I cant fathom thinking that shes had them already). Her rast for peanut was 71.20 at age 2.
Sara's 5 1/2 now, and has had PB once, a PB cracker, those darn orange ones... We've never tested her, and have told her the truth (you MAY be, but we're not finding out). With DW anaph, Caitlin allergic, and Meghan around, we'll pass on giving it to Sara. We've told her K teacher the truth, and do not want Sara near PB. She MAY be allergic.
Q: Should we test her? Would it matter? it would, in that we'd have an extra epi for her (She and Caitlin are the same size so C's epi-jr would be fine). If it comes out +, we dont know for sure (false +?) a negative could be a false -.
So what good is testing? Go under the asumption that shes allergic, and have a plan JIC. Unfortunately, we dont have a plan in place. Suppose we should have one. Quickly.
Jason
Caitlin 4-17-00 Allergic to Dairy, Egg, Wheat, Bananas, Grapes, Rye, Sesame, Beef and Avoiding Latex and all Nuts
Sara 2-13-98 NKA (avoiding nuts)
Meghan 2-28-03 dx'ed Reflux - Alimentum feeder, Zantac - 1.2ml 2x/day
[url="http://community.webshots.com/user/jtolpin"]http://community.webshots.com/user/jtolpin[/url]

Posted on: Wed, 09/10/2003 - 3:24am
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Joined: 05/28/2009 - 16:42

My son is 3 with PA from the time he was a year and a half. My other son was never exposed to nuts but I had him tested anyway at his 1 year checkup. He may have been allergic to milk so he was being tested anyway. He came up negative on both, thank goodness. Their doctor said he could not be allergic to anything he has not been exposed to.
Jan

Posted on: Wed, 09/10/2003 - 4:11am
CorinneM1's picture
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Joined: 06/20/2002 - 09:00

Interesting question...something I have been thinking a lot about lately as well. My 2 year old son is PA, and I am expecting our second child in December. When we had Aidan tested (bc he broke out into hives after eating a small pc of his dad's bagel with peanut butter at 14 mons)we had him RAST tested at the same time as his lead screening. Meaning, they were going to take a vial of blood for the lead screening and at that point another vial was nothing.
I would like to speak with my ped when child #2 has her (we are having a girl) lead screening btw 12-14 months to see if she would run a RAST test on her as well for food allergies. I don't know if she would do this if there are no symptoms, but I would like to find out as soon as we are able.

Posted on: Wed, 09/10/2003 - 4:18am
joeybeth's picture
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i don't know how my second child could have been exposed to peanuts, thereby causing her to develop the peanut allergy. as far as i know, she was never exposed to peanuts before testing occurred (which was very much positive). she wasn't given peanut containing foods or exposed to peanuts in utero througy my diet. we did use to be very ignorant about may contains being in their environment and even occasionally let the two pa girls eat them....maybe that explains it. ??

Posted on: Wed, 09/10/2003 - 5:14am
samirosenjacken's picture
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Joined: 09/30/2002 - 09:00

Dr. Wood at Johns Hopkins told us it would be a waste to test the boys before they turned 4. He said for some reason they are finding that age 4 is the magic age. Before 4 you could get a false negative. But if they are negative at 4 you can be fairly certain they will not be PA. He said if we tested early (which we have already not knowing this) we could get a negative.. feel they are neg and expose them to peanuts and then they would become PA. If we wait... we stand a better chance at a true negative (unless they are pre disposed and are going to be allergic regardless). So we are waiting till both boys are four before having them retested.

Posted on: Wed, 09/10/2003 - 6:43am
CorinneM1's picture
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Joined: 06/20/2002 - 09:00

So, by that theory is his thought not to introduce nuts into the diet till the age of 4 as opposed to the recommended age of 3 now?
Since introducing is a form of testing....

Posted on: Wed, 09/10/2003 - 7:09am
MJMD's picture
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We got the CAPRAST results back on our 11 1/2 month old DS - no known allergies, just some eczema (we have an almost 3 yr. old PA DS). Our 11 1/2 month old tested negative for milk, soy, egg and peanut...thank God. According to our allergist (at A.I. DuPont Hosp. for Children), if he was exposed in utero or while breastfeeding, he would show the antibodies in his blood. I'm going to start dairy for him, then egg, but hold off on any peanuts until he's 4. From research that I've done, the CAPRAST is supposed to be very accurate for these 4 allergens. As of now, my 3 yr. old PA DS has tested negative for almonds, pecans, sesame and coconut. Our allergist does not want to do any food challenges until he is 4. He said we'll do another CAPRAST (one when he turns 3, and another at 4), and if it turns up negative for the tree nuts again, we'll do a skin test to see if it's negative. If both the CAPRAST & skin test are neg., then we'll do the food challenge. I like this allergist b/c he's not crazy with the skin testing - I don't want to expose him to any type of nut! He also told me not to give him coconut or sesame until he turns 4 b/c the proteins are so similar to the peanut protein. I thought that was pretty intriguing & something you might find of interest.

Posted on: Wed, 09/10/2003 - 10:20am
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We had our now 17 mo old tested at 9 months. Her older sibling was positive at the same age tested positive for egg, dairy and peanut. All of which were at anaphylatic levels.

Posted on: Fri, 09/12/2003 - 3:42am
jtolpin's picture
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Joined: 05/28/2003 - 09:00

Quote:Originally posted by deeanne26:
[b]We had our now 17 mo old tested at 9 months. Her older sibling was positive at the same age tested positive for egg, dairy and peanut. All of which were at anaphylatic levels.[/b]
Can I ask what that means? Is there such a level, or did you just mean her older sib was rast at >100? Because Caitlin's rast for egg/milk are >100, but when BF, the only reaction thru BM was eczema flares, no anaph. We've been egg/milk free now for 2 yrs, and never had anaph. I dont consider her anaph to either, just highly allergic. I dont know WHAT her reactions would be if she had a glass of milk (or a cookie with milk)
Jason
Caitlin 4-17-00 Allergic to Dairy, Egg, Wheat, Bananas, Grapes, Rye, Sesame, Beef and Avoiding Latex and all Nuts
Sara 2-13-98 NKA (avoiding nuts)
Meghan 2-28-03 dx'ed Reflux - Alimentum feeder, Zantac - 1.2ml 2x/day
[url="http://community.webshots.com/user/jtolpin"]http://community.webshots.com/user/jtolpin[/url]

Posted on: Tue, 09/16/2003 - 5:51am
Anonymous's picture
Anonymous (not verified)

Sounds like most are doing RAST on young siblings. Anyone done a scratch on a young child? (About 1 yr old) and why or why not?
Michelle

Posted on: Wed, 09/17/2003 - 1:03pm
Anonymous's picture
Anonymous (not verified)

My 1 yr old had his 1st allergist appt today and I asked about the accuracy of allergy tests when theoretically there's been no exposure. He said you CANNOT test positive for a substance you have never been exposed to. He said very frequently though he has people test positive who's parents swear there's been ABSOLUTELY NO exposure, even prenatally or through breastfeeding. However, they must at some point have been unknowingly exposed. When you consider all the cross-contamination issues, I suppose this is the most likely scenario. My 3yr old had a reaction to residue on the counter at McDonalds...even if you are not eating peanuts, it's impossible to avoid so I suppose if you are pre-disposed to be very allergic to peanuts, it might take very little to sensitize you???
Michelle

Posted on: Thu, 09/18/2003 - 4:46am
MJMD's picture
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We got the results back on my almonst 1 yr old son. We did a CAP RAST for peanut, egg, milk, and soy. All came back negative, so the allergist said we could introduce dairy & egg (which he's had none of, except in exposure through BM). My almost 3 yr old is PA, and we are avoiding all TN. I was really glad everything for my youngest came back negative, and so happy I would finally be able to feed him something besides plain, unsalted rice cakes :-) BUT, We tried a few tablespoons of yogurt, and he got 2 little hives around his mouth; same thing the next day. I didn't give him any benadryl b/c the hives didn't change, and they went away in about 30 min. I thought maybe there was an additive in the yogurt that was bothering him, so I tried a slice of American cheese on the 3rd day. 2 days in a row, same thing, a few hives around his mouth. The 2nd time we tried the cheese though, I let him feed himself, and this time he got 8-10 hives. So we stopped there. The hives were NOTHING in comparison to what I went through with my oldest the first time he had a tiny taste of PB, and he had an anal. reaction.
I called the allergist, and they said not to give him any dairy, and to bring him in for a skin test...which I can't get an appointment for him until 10/23. They told me the CAPRAST was 85% accurate, and should be followed by a skin test if negative. If I had been told that the first time we were there, I would've had a skin test done to double check the egg & dairy before giving him dairy. So now I'm trying to take the crash course on dairy allergies, and make a dairy-free, P/TN-free and safe birthday cake for his 1st b/day tomorrow. UGH. If we end up with one PA son and one Dairy allergic son, I guess we'll all be eating a lot of salad.
Any experience you've had with possible dairy allergies, I'd appreciate any kind of feedback. This site had been an invaluable source to our family. I admire all of you for being so strong.

Posted on: Thu, 09/18/2003 - 5:01am
Heather2's picture
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Joined: 09/25/2001 - 09:00

Deanne...you didn't say what the test results for your 17 mo were. We, too had our younger son tested at 9 mo (he is now 15 mo). At that time, he was being tested for milk so I thought, if they're going to puncure his vein anyway, why not just test for peanuts and tree nuts. Everything was negative. The allergist has told us to be aware that he could test positive any time in the future, though. I guess we'll re-test him around 3 or 4 yo. His older brother, age 4 1/2 is the one with the PA/TNA.

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