Posts
Basically, his scores reflected allergies to what we expected. The allergist did not test for apple despite me asking her to (Frustrating. But I won't dwell on it) or peanut (which she meant to have checked but is irrelevant for now because there's no way we're giving it to him). His scores were:
Sesame 19.9
Egg 13.5
Milk 6.94
Wheat 3.49
Tree nuts 49 (positive to four different nuts, but cashew and pistachio are the highest)
Basically, anything above .35 is technically a positive (allergic) score, so those are all positive. The higher the number, the more likely he is to react, but it doesn't necessarily tell us anything about the severity of the reaction that he would have. It's difficult to interpret the scores (but you know I will be googling like a fiend trying).
His wheat score is VERY low. It was even lower when he first tested positive (.54). The allergist tells me that a score of 3.49 makes it 95% likely that he can clinically tolerate wheat! She recommends we schedule an in-office challenge (take him in to her office and let him eat a cracker). I'm not sure if I'm comfortable with this or not. If there is only a 5% chance that he's allergic to wheat, then I feel mean depriving him. On the other hand, he reacted on the skin prick test twice (if I understand her correctly, the allergist said that his body could still react to the skin prick even after he can "clinically tolerate" the allergen). I would feel more comfortable if he could talk and tell us if his tongue felt funny or he was itchy or whatever. But, the risk of anaphylactic reactions to wheat are rare at least.
So, that's where we stand. I'll have to decide whether I want to do an in office challenge, and in any case, she'd like to see him back again in 6 months. He actually had a reaction this morning at a coffee shop. He only ate the same safe foods he eats every day (gluten free pancakes, freeze dried blueberries, orange juice), but he broke out in a red blotchy rash all around his mouth. It went away after we got home and I washed his face and hands without benadryl, though. I figured it was wheat from the highchair, table, etc. But I guess it could have just as easily been egg or milk.
This is his back mid-test when I took him for the skin prick last week. That huge one is his egg reaction. The other reactions on the left are wheat, milk, and nuts, and the one on the right is sesame. Poor guy. He never scratched once, though, and (after a super strong steroid cream) was all clear within a few hours.And we made it up to him the next day (if you don't know how much our son would have enjoyed this tractor ride, check out our other blog, Chronicle of an Infant Bibliophile and our many reviews of books about transportation):
What do you think about trying the in-office challenge? Think we should give it a try?
Poor kid!!
ReplyDeleteI would do the in-office challenge. I know someone who still reacts on the skin test but has been able to eat... whatever it was... for years now.
I've also heard of people who ONLY react if it gets on their skin, and absolutely nothing happens when they eat it!
A challenge might be what we end up doing with peanuts, rather than another testing... need to wait at least a few more months before I even bother asking. :) You could challenge apple, too, if you're still concerned.
We were originally worried about fresh fruit, too, but it turned out he just had eczema on his face, partly from having juice on his face but it wasn't an allergic reaction to the juice.
(Does that even make sense? I shouldn't type this much this late.)
Hang in there.
Ouch, that egg reaction looks really uncomfortable!
ReplyDeleteI would try the wheat challenge, it would make feeding him so much easier if you didn't have to avoid it.
I've heard apples are really hard to test for, because there are so many different types and you can be allergic to one kind and not another? And then apple juice is often made from a bunch of different apples mixed together...
Britt, I know just what you mean about the rash around the mouth from foods, especially if they're acidic. I think a peanut trial is scarier than wheat, but at least your kiddo will be under supervision. Better than taking a bite of PB&J at home, that's for sure!
ReplyDeleteMaryAnne, that's interesting about the apple testing. I had never heard that and it makes me feel better about being ignored by the allergist. My brother is allergic to apples (among many other foods), so that's what made me a little cautious I guess. I just read this online:
"Like many other allergies to fresh fruits and vegetables, apple allergy can take two different forms. In the North of Europe, people with birch-pollen allergy can develop an apple allergy due to the similarity between a protein in birch that causes birch-pollen allergy, and an apple protein. This is called the birch-apple syndrome with symptoms generally appearing within 5-15 min after consuming raw apple and comprising local reactions in the mouth and throat with itching and inflammation (called oral allergy syndrome, OAS). The molecule, known as an allergen, involved in this kind of allergy does not survive cooking and pasteurisation. Therefore, people who react to this allergen can tolerate cooked apple and juices. Individuals often develop adverse reactions to other fruits including pear, apricot, melon, banana, nuts such as hazelnut, or vegetables such as celeriac (celery tuber) and carrot.
In Mediterranean countries, people with apple allergy do not have birch-pollen allergy. Instead they often have allergy to peach. These individuals develop adverse reactions to apple because of the similarity between the allergens in peach and apple. Symptoms are more severe including generalised urticaria, abdominal pain, vomiting and life-threatening symptoms, sometimes in addition to the OAS. These individuals tend to have more frequent and severe reactions when fruits are eaten with the peel. They also tend to develop adverse reactions to other fruits including peach, apricot, plum, cherry, nuts (such as hazelnut and walnut) and peanut. The protein (allergen) that causes this kind of allergy is tough and the allergenicity survives in processed foods such as purees, nectars and juices. As a result, individuals with this kind of allergy cannot eat even processed apple.
The amount of allergen in the fruit is influenced by the apple variety, the degree of maturity and storage conditions. Whereas over-mature and freshly harvested fruits have highest levels of the peach related allergen, long storage increases the levels of pollen-related allergen. No hypoallergenic fruits have been produced by breeding so far. "
Source: http://foodallergens.ifr.ac.uk/food.lasso?selected_food=2
My little guy eats peach all the time, so if anything, he'd be the first of the two, but hopefully he's neither and just the victim of a worry wart mom. :)
That is really interesting. Who would have thought that birch pollen would have anything to do with apples?
ReplyDeleteWhen I had my little one tested for fruits, the allergist actually had me bring in samples-- the strawberry jam that he'd eaten when he got the rash on his face, a fresh pear, that kind of thing.
Gratefully he doesn't really even get the eczema much anymore, but that could be partly that he's older and doesn't make as big of a mess and partly that it's been winter and there haven't been as many good fresh fruit options.
Poor baby :( That egg reaction looks like the cashew reaction my daughter had on her skin test. She also tested high for almond and pistachios.
ReplyDeleteInteresting post about RAST scores back, in these days oral allergy is very common and people have to try to be careful with their health, for example I unfortunately buy viagra only because I need it and well Im close to be a senior citizen.
ReplyDelete