Talking Allergies

My dd had her appointment with Dr. Waserman today. She was tested for environmental allergens and an assortment of foods, including peanuts and tree nuts.

She reacted to dust mites, cats, dogs, horses (4+), to coconut (3+), eggs (2+), but because she eats coconut products and eggs all the time, the dr. was not concerned and told her to keep doing so.

When it came to tree nuts, a lot of them were a 2+, but to our surprise, peanuts were barely a tiny 1+!!!! The nurse had to look very closely. She even repeated the peanut on the other arm, with the same result.

So Dr. Waserman said that that wasn't conclusive enough (because, allergies being what they are, she could retest her next week and get a more severe reaction), and therefore ordered a RAST test. She recommended that she keep avoiding peanuts and tree nuts, and she will see her again in 2 months. If the RAST test comes back negative or very low, she'll then proceed to a food challenge.

They tested her breathing however and her lung capacity is not great, even though she is on Advair and Ventolin. They are also testing her for sputum, to check for acid reflux, as this could be causing her reduced lung capacity, if I understood correctly.

Has anyone noticed their skin tests varying from one time to another (for ex. going from 1+ to 4+, or vice versa)?

We have had conflicting results also. My daughter was tested at 14 months for a suspected milk allergy. At the same time Dr. Gold suggested that egg and peanut be tested for also. All were positive. She has never eaten egg or peanut that we know of. Since that time (she is 4 and half now) she has had one negative skin test to peanut but her RAST was high at 10. Her egg RAST is low at .55 but her skin test to it is always very large. Given her young age, the doctors at the Sick Kids allergy clinic opted to wait for any oral challenge. It is frustrating for us since she might not even be allergic to egg and peanut but we do not want to risk a challenge in case she is.

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11 year old daughter -- lives with life-threatening allergies to milk, eggs and peanuts; seasonal allergies (birch, maple, ragweed); pet allergies; asthma; and eczema
9 year old son - no allergies

Hi Nicole, I just read your post - wow! It's hard to know what to think, isn't it? I'm sorry I can't help you with answering your question, but I just wanted to let you know that I read your post. I have heard that skin testing is an indicator test, and not always 100% accurate, but still considered a good method for testing. It sounds like your daughter will definitely need the followup testing in 2 months to sort this out. Obviously she reacted to something... did the doctor or nurse offer any suggestions as to what they thought, or do you feel absolutely certain that it had to be peanut?

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14 yr old daughter: no health issues
11 yr old son: allergic to peanuts, tree nuts, eggs, fish, sesame, sunflower, mustard, poppy seeds, green peas, some fruits, instructed to avoid all other legumes (except soy & green beans), pollen, cats, horses

Is she being seen by a pediatric respirologist?

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Moderator
Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb

Well, her reaction occured 25 minutes after eating an English muffin with peanut butter, so I automatically assumed it was peanut butter, peanuts being the most common allergenic food. She has since eaten the same English muffin with no problems. She ate the English muffin and peanut butter around 4:30, which was well after lunch and didn't remember eating anything else that afternoon. The E.R. doctor was also pretty sure, but no one can be 100 % sure without testing, I suppose. Even then it doesn't seem to be an exact science.I

t's kind of an emotional roller coaster. We were sitting there after the skin scratch, waiting and watching the peanut butter one and getting excited because we couldn't see much happening.

Oh well, guess all we can do is wait!

Hopefully the RAST test will tell us more. Does anyone know what the RAST test's level of reliability is? (False negatives vs. false positives)

Nicole, it would be stressful not knowing, but it sounds like you have a great allergist. Sounds like she is really thorough.

I've had negative skin test results to soy before (but I am definitely allergic!)

I've also had varying positive results. In Oct. 2004 I was tested for all the foods, and I reacted quite a lot to some things. It took several days for the hives to disappear completely. Several months later my allergist tested me again---I still reacted to most of the same things, but I didn't react as badly.

The first time around I asked not to be tested for peanut or egg. The second time I asked not to be tested for peanut but accidentally got tested anyway---in both cases, the hives weren't totally out of control like I feared they might be. (I haven't been tested for peanut since I was a very small child. But I was tested for egg about 8-9 years ago and the hive was really large--I can't remember how large exactly, but it continued to grow when I got home....I think it was something like 10 centimetres long (but it wasn't that wide as I recall). It took long time to go down---maybe even a week (but it was a long time ago--can't remember exactly.)

So, yes, test results can vary. It might depend on the levels of histamine in the skin at that particular time (I'm guessing here.)

Susan,
So far, she was ever only seen by a pediatrician and the family doctor regarding her asthma. But since the clinic where the allergist is is called the Firestone Institute for Respiratory Health, I think they will do a full assessment and look at the whole picture with her and I am happy about that.

It was kind of strange to go in to find out about a peanut allergy and then being told she needs to have a chest x-ray and and an acid reflux test.

Helen,
Thank you for telling me about your testing. I guess from what you tell me, I won't get my hopes up about her not having an allergy.

I think the RAST is a good idea. It really should be the first option in children. I hate the thought of putting our little ones through all those pricks.

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2 year old son: allergic to milk--waiting to introduce other allergens

self: allergic to milk, eggs, soy and other legumes, corn, oats, wheat, turkey, tree nuts, yeast, fish