CAP-RAST scores and outgrowing PA

Posted on: Thu, 03/14/2002 - 6:37am
anonymous's picture
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Joined: 05/28/2009 - 16:42

I attended FAAN's allergy conference in Baltimore last weekend. There seems to be a lot of questions regarding CAP-RAST scores and outgrowing PA on this board, so I thought I'd share a bit of Dr. Robert Wood's presentation with everyone.

(For those of you who don't know, Dr. Wood has been conducting research at Johns Hopkins on outgrowing PA, is himself allergic, and is an excellent pediatric allergist. I speak from experience since he is my daughter's!).

Dr. Wood's research originally showed that about 21% of children outgrow their PA; an update on this research indicates the number is slightly higher! Even some children who experienced severe reactions have been known to outgrow their allergy (although the odds were better with milder reactions). A RAST less than 5 means 60% likely to outgrow; a RAST less than 2 means 70% likely.

Dr. Wood said he would not consider a food challenge unless the RAST was less than 5. He said he would not bother to do a skin test to confirm an outgrown allergy because there is such a high false positive (however, false negative skin tests are uncommon).

He said a very important key to outgrowing allergy is strict avoidance -- even foods that don't seem to cause a reaction can still affect the ability to outgrow peanuts if the protein is present even in small amounts.

He also noted it was important not to base your treatment plan on IgE levels -- that they are not necessarily proportionate to one's reaction. Also, he said EVERY peanut allergy is potentially life threatening -- that previous reactions do not necessarily predict future reactions.

But on a positive note: he believes we are 5-10 years away from an effecive treatment! Let's pray he's correct!

If anyone has an opportunity to attend a FAAN conference, I highly recommend it. I found it very informative.

Posted on: Thu, 03/14/2002 - 6:48am
smack's picture
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Joined: 11/14/2001 - 09:00

Kami's Mom,
Thank you, that was very informative and well written!

Posted on: Thu, 03/14/2002 - 10:11am
BENSMOM's picture
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Joined: 05/20/2000 - 09:00

Thanks Kami's mom. I also went to Dr. Wood (just once.) He gave me good info. Thanks for posting.

Posted on: Thu, 03/14/2002 - 10:22am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

Just for clarification here, is that a CLASS 5? or is this 5 kU/L IgE? (which would be what, class 2?)
Obviously, there is a substantial difference!
Very good information!

Posted on: Thu, 03/14/2002 - 12:32pm
kcmom's picture
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Joined: 12/18/2001 - 09:00

When you said about strict avoidance, even to foods that don't seem to cause a reaction, does that mean any food in the legume family. Of course we avoid anything that may contain peanut or any nut anything, that's given. But, my daughter does eat green beans and peas with no problem, should we avoid these also as they are in the legume family. Also should we avoid things that have a reported cross reaction for people like gums (guar, xanthum etc). She has had no problem with these either, even though I still watch for them, she had them before i knew they may cross-react. My daughter scored a 5.94 KU/L so we are on the line and I want to give her every possible chance to grow out. Thanks!
kcmom

Posted on: Fri, 03/15/2002 - 1:33am
anonymous's picture
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Joined: 05/28/2009 - 16:42

In response to questions:
Corvalis Mom: 5 refers to the actual CAP-RAST score, not the classification (sorry, I don't know the units of measurement).
kcmom: When Dr. Wood referred to strict avoidance, it's my understanding he was referring to the cross-contamination issue. The main culprits he cited for this were baked goods, candy, ice cream, and ethnic (esp. Chinese) foods. He seemed to be concerned about parents feeding their children these types of foods, reasoning that since they don't react they must be ok.
He did not mention avoiding other legumes. However, he did tell me at my daughter's last appointment that she should avoid lentils. He said they are the only other legume cross-reactive with peanuts. Hope that helps to clarify.

Posted on: Fri, 03/15/2002 - 10:25am
kcmom's picture
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Joined: 12/18/2001 - 09:00

Thanks Kami's mom, that does help! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] I had myself a little panic there thinking maybe I should not be feeding her veggies! I'm okay otherwise because I do not feed her any of the others. Only homemade things from scratch so we know exactly what is in. My mom is loving making homemade ice-cream! Thanks again!! [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]
kcmom

Posted on: Mon, 04/22/2002 - 12:35pm
brenda's picture
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Joined: 01/22/1999 - 09:00

Kami's Mom,
Thanks for Dr. Wood's info on lentils being the only legume cross-reactive with peanuts. My PA daughter eats peas and string beans and has been tested for many legumes by CAP RArST-- they only legume she tested positive for was Lentil (she has never eaten it)!

Posted on: Thu, 05/09/2002 - 11:21am
Sandy's picture
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Joined: 05/27/2002 - 09:00

Great information! I thought that once you have a severe allergy to peanuts, you never grow out of it. You just gave me a little hope. I also heard 8 years ago that that were coming up with a blocker for p.a. people. Now you say that we have to wait another 5-10 years more! What a drag.... Oh well, at least they are working on it! My allergist said to stay away from peas, beans (anything that is a legume). The only green veggies we eat are broccoli, asparagus and occasionally cabbage.

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