DD's uknow peanut test results

[Jessica]

Got a call today and they said she tested positive on all components and is in the 'severely allergic' category. So disappointed. And I'm wondering how, in all these years (at least 2 of which we had no idea what to avoid and she had lots of what was considered "risky" items like cheese cracker sandwiches which at the time, was considered cross contaminated and very risky) and having pb and pb products around her when she was little she has never had as much as a mild reaction (only occasional mystery hives which usually didn't happen anywhere near any possible contact). Is there anything else I can ask them for clarification? Or is it pretty much cut and dried?

I'm afraid to tell her. When we had the test done I was careful to let her know it wasn't to find out IF she was allergic but only to learn about treatments and such down the road but the dr mentioned the skin test being a possible false positive so she was very hopeful. And to make things worse she was so much more paranoid on vacation than I'd ever seen her even with places we normally trust.

[CMdeux]

My guess, Jessica, is that your DD has probably just got a fairly high threshold dose, or at least historically she has.

That has nothing to do with severity, as far as I can tell, other than making those who are unlucky enough to come up on the losing end of both measures are at very much enhanced risk of fatality.

She has a little more 'breathing room' than some people, in other words.  It's not a reason for less caution, obviously.  But it might be worth a little peace of mind for you both?     Sorry that it wasn't the result you'd have both liked. 

[Mfamom]

we just got ds test back.  the nurse didn't really explain it that well, but she said the 2, 1, 3, 9 were very very low and the 8 was high?  dr wrote a note suggesting we do a challenge.  anyone understand the components who can chime in?

[CMdeux]

2 (and maybe 4, which isn't one of the components I guess) are usually the ones associated with fatality risk.

8 is usually not-- usually that one is associated with more benign clinical allergic responses.

But I'm working from memory here. 

[booandbrimom]

we just got ds test back.  the nurse didn't really explain it that well, but she said the 2, 1, 3, 9 were very very low and the 8 was high?  dr wrote a note suggesting we do a challenge.  anyone understand the components who can chime in?

That's excellent, MFA!

Ara h 8 is associated with birch pollen cross-reactivity. That's the whole reason they're doing this test - people who score high on 8 and low on the others are likely to be false positives. Wouldn't THAT change your life!

More than you ever wanted to know on my blog (which I'm not going to flog here).

[booandbrimom]

Sorry, Jessica...didn't mean to sound heartless for you guys. But I think most of us take the test and expect the bad answer. It's nice to see a good result for once.

I agree with CM on threshold. My son is allergic and we know he's likely to remain allergic all his life, but it's really reduced our worry knowing his threshold is high.

[Macabre]

We learned from component testing that 2 is elevated for DS. 

Mfamom--I'd challenge. I know he's not wanted to challenge treenuts, so peanut might be a toughie, but wow--it could be life changing.  Before dealing with college--heck, before dealing with dates in HS--knowing could be really helpful. 

[Mfamom]

Definitely would be life changing.  I'm cautiously optimistic, makes sense because he is really allergic to birch.  He did have ana reaction to peanut, but I guess he could outgrow?   His skin tests are positive, but rast negative.  So I have wondered for awhile if the skin was false.
Something else is wrong with him now, so i'm pretty focused on that.  We've been to four docs,  in the past week

[Macabre]

Oh wow. 

[Macabre]

Timely article!  It's older, but for some reason this was in my google alerts today. We tweeted this today (I don't this was cited upstream):

http://www.jaci-inpractice.org/article/S2213-2198(12)00019-0/fulltext#sec4

Advances in Diagnosing Peanut Allergy
Scott H. Sicherer, MD, Robert A. Wood, MD

Received 11 September 2012; received in revised form 8 October 2012; accepted 12 October 2012.



Component testing
Peanut, like any food, is composed of many proteins (Table III). An immune response directed toward one or another protein (component of peanut) may have different implications, depending on characteristics of the protein.44, 45, 46, 47, 48 Ara h 1, 2, and 3 are seed storage proteins, are stable to heating, and are considered the major peanut allergens associated with primary sensitization to peanut. Ara H 4 is an isoform of Ara h 3 and Ara h 6 is homologous to Ara h 2. Ara h 5 is a profilin, a plant pan-allergen, and Ara h 8 is a Bet v 1 (birch pollen) homologue, both of which are labile proteins, which are not usually associated with severe PNA. Ara h 9 is a lipid transfer protein that is stable and has been associated with more severe symptoms as well as oral ones, among patients in Mediterranean regions, and may be related to primary sensitization to the major peach allergen Pru p 3 or possibly other fruits.44, 45, 49, 50"

(There is more about component testing in the article.)

[twinturbo]

Excellent. Maybe I can take this in to current doc to come back to the topic of the test. Or maybe I'll just email previous doc to see what exactly the "new" RAST done on DS1 at Sinai was.

[yelloww]

Ds is really allergic to birch too. Is that test covered by insurance?

[Macabre]

Ours wasn't (and I've heard similar reports from others), but for some reason we didn't have to pay.

I'm going to hunt down the text DH sent me when he was at the alleegist with DS.

"We do the first drops today. Will do skin testing, blood testing. Component testing isn't covered by insurance. There's a $150 peanut only test but also a $195 ImmunoCAP ISAC test that covers airbornes and peanut which, if positive, means teh peanut comoenent test gets thrown in free. We're doing the ISAC."

[Mfamom]

I think that more insurance is covering it.  I didn't have to order the kit or anything.  they did the blood draw in the dr office and sent it out.  billed insurance which is aetna
thanks for that info, macabre

[ajasfolks2]

We've been holding out on this test in hopes we can verify that insurance will cover . . . just don't have that amount of cash for 2 kids currently.

If we had to choose which kid to test, it would be DD who has the high birch numbers, no ana to pnut experience, and moderate test numbers to pnut as well as SPT is very low too for pnut.  She is also OAS to cherries, peaches, apricots, nectarines . . .

Though I don't see us bringing ANY pnut anything into our home with DS and his ana reax history and contact reax history . . . at least until we've also done the uKnow for him and received GOOD answer (not holding my breath on that one).

I read this thread and I'm struck by how FAR we've really come in some aspects in the last 15 years.

Just need a billion $ poured into research and we'll have more answers.