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PostPosted: Wed Jan 06, 2010 2:53 pm 
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Joined: Tue Jan 05, 2010 12:18 pm
Posts: 3
I am new to this board. Too bad I did not sign up earlier!!

My daughter (5 and a half), was diagnosed with a peanut allergy about 2 years ago. She had been eating peanuts for about a year when one day, she had been eating some that my husband was shelling and started coughing. Our first tought was that she had ingested some of the little "skin" over the peanut but we did not take any chances and avoided all peanuts until she got tested.
Skin prick positive (about 2mm), RAST positive low (about 0.6 if I remember correctly).
Strict avoidance since. No allergy to other nuts and she continues to eat them regularly (ones that we shell ourselves).

Went back for a follow up to get tested a few months ago. Skin prick negative. Went back a few weeks later for another skin prick with actual peanut butter: negative again. Nothing. At. All. RAST test: still positive low but reduced to 0.46.

Allergist does not recommend challenge. Says that negative skin prick test means nothing since the RAST is positive. Says that there is a 50/50 chance of being allergic because of her initial reaction and does not think it's worth it. When I asked if it is unusual for an allergic child to have absolutely NO reaction to skin prick with peanut butter, she said she was concerned that I was not taking the allergy seriously. I thought I read that the skin test had a better predictive value for negative tests than the RAST?

Anyone have a take on this? I take the allergy very seriously but if there's a chance she's no longer (or never was) allergic, I want to know.

Thank you!!


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PostPosted: Wed Jan 06, 2010 3:12 pm 
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Joined: Mon Sep 05, 2005 12:53 am
Posts: 375
Location: Alberta
Interesting ... this year our son was skin-prick negative to walnut, but still positive with the RAST. However, the RAST positive numbers were down quite significantly from previous years. Our allergist said that this decline in RAST, coupled with the negative skin test was an indication that he was trending towards growing out of the allergy, and scheduled an oral challenge. My son, as I predicted, reacted with the actual crushed walnut at the challenge (skin prick positive to the actual walnut, then hives / swollen cheek when rubbed on his skin), but the allergist is still optimistic that he will grow out of it soon and has scheduled another challenge for next fall. :scratchy

You said the RAST was still positive - were the numbers down from prior tests? It's pretty complex how they figure this all out - the best description I have ever read was in the book by Dr. Scott Sicherer "Understanding & Managing your Child's Food Allergies". He gives lots of examples of different patients numbers, and puts it into language that is easy to understand. I took the book out of our local library, but will probably buy it.


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PostPosted: Wed Jan 06, 2010 3:40 pm 
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Joined: Tue Jan 05, 2010 12:18 pm
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Momtobunches wrote:
Interesting ... this year our son was skin-prick negative to walnut, but still positive with the RAST. However, the RAST positive numbers were down quite significantly from previous years. Our allergist said that this decline in RAST, coupled with the negative skin test was an indication that he was trending towards growing out of the allergy, and scheduled an oral challenge. My son, as I predicted, reacted with the actual crushed walnut at the challenge (skin prick positive to the actual walnut, then hives / swollen cheek when rubbed on his skin), but the allergist is still optimistic that he will grow out of it soon and has scheduled another challenge for next fall. :scratchy

You said the RAST was still positive - were the numbers down from prior tests? It's pretty complex how they figure this all out - the best description I have ever read was in the book by Dr. Scott Sicherer "Understanding & Managing your Child's Food Allergies". He gives lots of examples of different patients numbers, and puts it into language that is easy to understand. I took the book out of our local library, but will probably buy it.

We'll, that's positive for your son! At least your allergist appears to be helpful and assertive. Ours answers a lot with "I don't know" and "immunology is not simple you know".
You say your son's skin prick was negative but positive with actual walnut? The negative was with the solution in the allergist office? See, that's part of my confusion. She tested negative with actual peanut butter out of the jar. :dungetit

Our daughter's RAST numbers were down to 0.46 from about 0.60. They were not high to begin with.

Just put a hold on that book at the library :thumbsup


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PostPosted: Wed Jan 06, 2010 6:43 pm 
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Joined: Mon Feb 07, 2005 6:39 pm
Posts: 2948
Location: Toronto
Agree - Dr. Sicherer's book is terrific.

_________________
Allergic to soy, peanut, shellfish, penicillin


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PostPosted: Tue Jan 26, 2010 11:54 am 
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Joined: Tue Jan 05, 2010 12:18 pm
Posts: 3
Got the book. Great information!!
Went to see another allergist, this one a pediatric allergist. He did the skin test again - negative. The last blood work from 6 months ago showed 0.46 (vs 1.73 the first time 2 years ago. I had it wrong).

He thinks she is most likely no longer allergic to peanuts!! He ordered another blood test and if it low enough, we will be going for a challenge!!

Fingers crossed!!


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PostPosted: Tue Jan 26, 2010 12:05 pm 
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Joined: Mon Sep 05, 2005 12:53 am
Posts: 375
Location: Alberta
:happydance :happydance

That's fantastic!! Glad you liked the book ... it's my favourite go-to resource for food allergy questions!


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