Increasing RAST PA, MA & EA

Posted on: Mon, 08/21/2006 - 4:37am
Ree's picture
Ree
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Both my ds' RAST (ku/L) scores increased:

DS #1 - 4 1/2 yr old went from 0.9 to 2.3 for PA. His EA stayed around 2 or so.

DS #2 - 2 1/2 yr old's MA stayed around 2, peanut went from >.35 to negative (that's good news, but I don't trust it), and his egg shot up from 6 to 54!

Some questions:

- Has anyone's egg # shot up like this with strict avoidance?

- Does 54 ku/L mean lifelong or is he too young to say? Does the number mean he's anaphalactic to eggs? With PA, I would make that assumption, but do the numbers mean different things for the specific protein?

- Why would his MA be a 4+ and his EA be a 3+ on his skin prick test...would you think it would be the opposite?

I'm just confused and discouraged...

Thanks!
Ree

Posted on: Mon, 08/21/2006 - 5:04am
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Answers:
egg shooting up (no.. not THAT shooting up...) -- Scores go up/down just because... Avoidance IMO doesnt MAKE a score go down.. it keeps your child alive.
What does 54 mean? Nothing. It means the child is allergic now, and you avoid it until it hits <.35 and you challenge it. No more, no less. The number does NOT tell you waht type of reaction will occur, and you should, yes, assume the worst.
Why doesnt the SPT and the RAST coincide with each other? Because the wind was blowing (NSE or W - fill in your fave direction)... and move on, knowing that testing is NOT 100% foolproof, and there are 'issues' with inaccuracies.
Hugs!
Jason
------------------
[b]* Obsessed * [/b]

Posted on: Mon, 08/21/2006 - 5:40am
Corvallis Mom's picture
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Yes-- DD's egg numbers did this, with very strict avoidance and few mistakes (most of which wouldn't even matter to other EA). She started out with hive-only rxns to traces and RASTed about 2.0.... FF two years, and she was developing mild anaphylactic symptoms from cross-contaminated products run on shared lines. RAST was about 6. FF another three years...
With NO additional exposure other than very low level XC (again, pastas... thanks a [i]lot[/i] Barilla... [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img] )and a SPT, she began experiencing aerosol sensitivity to concentrated eggs. (You can't put a plate of scrambled eggs withint twenty feet of her.) Her RAST level was over 60. We don't know what it is now, but it hasn't improved any in the clinical sense.
With that said, I don't think the number means much. EA is [i]very infrequently[/i] the equal of a PA, but this is DD's reality. Her allergy is NOT going in the right direction to be going away. Period. We've accepted that. (But it does kinda make you feel annoyed that [i] you're living Murphy's Law,[/i] huh?)
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
And Jason?
Quote:
Why doesnt the SPT and the RAST coincide with each other? Because the wind was blowing (NSE or W - fill in your fave direction)...
I always thought it was related to the phase of the moon or the tide tables somehow... [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img] Wind direction, huh?

Posted on: Mon, 08/21/2006 - 7:31am
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Thanks for making me smile about this Jason! Your posts always do! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
Corvallis Mom - It's strange b/c my ds never had a reaction to egg that I know of. He's had mysterious reactions tons of times, but we've always chalked it up to milk or dermatographic skin. I was thinking his initial RAST of 6 was a false positive. He's never had eggs except when I was breastfeeding (which counts). And, obviously cross-contamination...he lives on Barilla pasta. Like you said, most EA kids have no problem with this. I'm horrified to think what would happen if he did. How old is your DD now? Does your allergist assume it's lifelong?

Posted on: Mon, 08/21/2006 - 8:32am
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Joined: 03/12/2004 - 09:00

Hey Ree!! [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]
We're in a similar boat. My ds just had his CAP RAST repeated at age 4.
Peanut, which had been going down for two years, jumped up from 20 to a lovely 47 [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img]
Egg has climbed steadily for 2 years, and is also in the 40's.
Milk is around the same, very low (some good news)
My allergist, whom I do like and for the most part agree with, the same guy who once told me...he'll outgrow milk and egg by 3, now says....with kids around 4 who are still allergic, the #s go up before they go down and we'll know better around 6 or 7. JOY! OH JOY!
As far as I know, 1 peanut exposure last year (the whole sippy cup thing), but I don't relate it to that for some reason. And no egg reactions. We too eat Barilla pasta with no problems and I did ask him about this if we should stop eating it. He didn't feel it was necessary, and I'm not ready to go to rice pasta, so we're sticking with it for now.
I'm really starting to buy into Jason's theory of how the wind blows may be equally as accurate as these d@#$ tests, but it did bum me out with the results.
Hope everything else is well and baby is good! Meg

Posted on: Mon, 08/21/2006 - 9:05am
Corvallis Mom's picture
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DD is now 7yo. [i]He[/i] says "almost all of them outgrow..." but he's starting to use a much more half-hearted tone... DD actually pretty much snorted at him the last time he said that to her.
Her allergy to eggs has always been severe-- she's NEVER ingested anything but well-cooked traces, and that only a few times. We probably should have used Epi two of those times.
Anyway-- I have a theory as to why some kids outgrow and others don't... it is only sort of scientifically tested, though. My hypothesis is that with egg allergy, there are people who recognize the "native" form of the protein (as it comes in raw egg) and are only truly allergic to undenatured protein found in raw or lightly cooked eggs... so they readily tolerate eggs well-cooked in baked goods or in pastas. That kind of thing. The other type of egg allergy is sequence specific, so just killing the protein with heat doesn't do any good. Your IgE recognizes a certain ten amino acid sequence that is exposed on the native protein, but hey- it's [i]still there when you cook it[/i]. Egg allergy is unusual because people can have either type of allergy, though the former is most common in children. Most food allergens tend to elicit one type or the other. Here's the hypothesis part-- my feeling is that the latter type are much less likely to be outgrown. It just seems like anecdotally the kids who outgrow egg are the ones who mostly had trouble with it raw.
But hey-- maybe it just depends on the tides. [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]

Posted on: Mon, 08/21/2006 - 12:12pm
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Hey Meg! Good to hear from you on this post! I'm sorry about your results... [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] I like what your allergist had to say. It still gives me hope. And the baby's great, thanks for asking! He makes me want another one! [img]http://uumor.pair.com/nutalle2/peanutallergy/eek.gif[/img]
Corvallis Mom - I like your hypothesis. It sounds right to me. 2 years ago I was at a conference where Dr. Sampson spoke and he mentioned people working on RAST or SPT for cooked vs. raw egg. Is it available yet? He gave a great explanation on how proteins & mast cells work and talked specifically about how the egg protein changes it's characteristics when cooked...very interesting. If I knew then what I'd be up against, I'd have paid more attention and taken notes! [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img]
I'm starting to believe it's out of our hands. I thought strict avoidance would help them outgrow it, or at least quicker, but not I'm not so sure. My ds had 2 pretty major milk ingestions and his levels didn't increase at all. He had no egg exposures (we're an egg-free house) and his levels skyrocketed! I'm with Jason on this one...

Posted on: Mon, 08/21/2006 - 1:06pm
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Joined: 06/23/2001 - 09:00

a well known allergist said that an exposure to an allergen (ie during a food challenge) does not decrease the chance of outgrowing that food. Although, we stopped SILK soymilk products after i found out that they run the soymilk on a dairy line and test the milk every 15 min for dairy and ever since, DS eczema is basically gone and his milk CAP RAST is going down down down (started at 25 and went down and then back up to 14 in 2003 and now slowly back down to 1.8 and he may actually outgrow it!)
DS just outgrew his egg allergy a week ago. He will be 8 in a week or so. He is also TNA and MA. His egg CAP RAST has been zero for about 4 years though and has failed two prior egg challenges even with zero CAP RAST due to concurrent asthma and eczema(last challenge was 2 years ago) but passed it last week. He has since eaten egg in baked goods every day as we were told to do and has had pancakes and today had another french toast without a problem. so we are pushing egg every day for the next 6 months before we let up. he may be so tired of egg by then! i actually like all of our food recipes without the egg in it better! Egg CAP RAST at age 1 was 18 and has gone down since then.
MA is down to 1.8 which is awesome and all TNA are now negative except for brazil nut down to 3.4, and pecan and walnut down to 0.5. we were so incredibly happy for DS when we got this info back in july. he is not PA and we re-introduced peanuts in july and have been pushing that daily as well. not sure what is right but wesley burks at duke is doing a study giving small amounts of the food allergen orally each day and finding that larger doses can then be tolerated but daily small doses are a necessity. interesting.
hang in there. i suspect when our kids are around 20 , there will be a solution to these crazy food allergies.

Posted on: Mon, 08/21/2006 - 11:27pm
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Joined: 04/02/2003 - 09:00

Corvallis Mom, I like what you said about the egg allergy. Makes sense. I always wondered why DS could have a baked good with eggs, but if he touched the whites of a raw egg, he got pretty itchy.
He did outgrow eggs according to rast and skin test, but if he touches raw whites, he still becomes a bit itchy. One day after he outgrew, he ate a lot of scrambled eggs and got the hives around his mouth.
This was a bit confusing. I just figured he ate too much at once?

Posted on: Wed, 08/23/2006 - 1:49am
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Joined: 08/23/2006 - 09:00

My DS now 4, had his PA RAST shoot through the roof. It went from a 44 to >100 in 2 years with strick avoidance of all peanuts and tree nuts. The allergist seemed stymied by this and could offer no answers. I am now completely freaked out.

Posted on: Wed, 08/23/2006 - 4:43am
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Joined: 02/22/2006 - 09:00

kat925~
My dd, who will be 4 in a couple of weeks, just got her RAST results back. Her PA # is now >100, up from 27.8 last year. We have had no reactions, accidental exposures, NOTHING. Also, to make matters worse, last year her allergy to cashews was "outgrown", a ZERO!! I had them retest it this year and she's allergic again along with pistachios. UGH. No exposure to tree nuts in the past year either.
I give up!!!!!!!!!!!! We'll be a peanut/tree nut family for life!
[This message has been edited by stephbillalec (edited August 23, 2006).]

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