Help me put the puzzle together?

[Frosted Crunch]

Let me start off by saying 


January 31st, My 7 year old son presented with Hives. I figured it was from this new cereal he'd had for the first time (frosted toast crunch). I was so freaked out that i took him to the doctor that morning. The hives weren't going away. He was able to predict where the next one would be, it was nuts.

On February 6th, my kiddo complained about throat squeezing, and tickling. He was still having the hives daily at this point. Every time the benadryl would wear off the hives would pop up.

I started him on zyrtec also.

I took him back to the pediatrician. She was very concerned. She RX'd him an epipen, an inhaler, and some oral steroid. She also recommended we take him to the allergist.


So i took him to the allergist. They did a panel of tons of environmental and the top8 allergens. This was the result.



It really didn't show anything conclusive.

Well i posted this on another forum, and she (she's on here, she referred me!  ) connected that two of the trees are legume trees. That set off a wildfire of lightbulbs.

Backstory:

January 30th, I had him cut the ends off of green beans, and we had refried beans with dinner.

January 31st, onset of hives, 5 minutes after eating frosted toast crunch.

We went to a Superbowl party, he had some hummus. (he woke up at 3am with hives)

Monday 2/6 he had fresh green beans in his lunch. He told me he had hives at school. That night he had hives.

Tuesday 2/7 we had the french toast with cinnamon for dinner.

That (tuesday) night was the first night that his throat had been tickling/squeezing (his words) up.

He's been having green beans at least 2-3 times a week since the beginning of january.

Make sense?

[YouKnowWho]

Has he had green beans prior with no issues?  Am I correct in understanding that no food alleriges were detected?  (I am not discounting test results, I have a child that reacts to everything on tests with only a few confirmed allergies and another child who reacts to little on tests but has numerous confirmed allergies including many legumes).  Have you been keeping a food diary complete with reactions?

Any changes in meds or any meds prior?  (I ask because my drug allergies can cause periodic hives for weeks after because meds can have a longer half life in your body than food).

Has he have ever had unexplained hives with illnesses or no particular reason?  I have a food allergic kiddo who has the fun of having full body hives with no traceable reason.  Part of his atopic history. 

Are you in a part of the country that is having a mild winter.  I am in the southeast and our pollen counts are already rising.  Oh joy. 

Have you recently moved, acquired pets, had a pet visit, changed laundry detergent, soap or shampoo?

[SilverLining]

He was able to predict where the next one would be, it was nuts.

I used to say it felt like there were bugs under my skin.  It's how I could predict where a hive would develop.

~~~

Sorry, I can't help with test results.. I'm sure others will be here to help though.

[Frosted Crunch]

Has he had green beans prior with no issues?


Yes, every few months, but we've upped our intake of them 100% since the new year.


Am I correct in understanding that no food alleriges were detected? You would be correct. They didn't test for green beans or any other legume (besides PB)  (I am not discounting test results, I have a child that reacts to everything on tests with only a few confirmed allergies and another child who reacts to little on tests but has numerous confirmed allergies including many legumes).  Have you been keeping a food diary complete with reactions? Yep. I just started a few days ago (since monday)

Any changes in meds or any meds prior?  We started on benadryl 1/31. That was the only thing he'd been given in forever. (I ask because my drug allergies can cause periodic hives for weeks after because meds can have a longer half life in your body than food).

Has he have ever had unexplained hives with illnesses or no particular reason? 

Not that i'm aware of. He's pretty much a healthy kid. I never would of expected to see him in the allergists office, at all.



I have a food allergic kiddo who has the fun of having full body hives with no traceable reason.  Part of his atopic history. 

Are you in a part of the country that is having a mild winter.  I am in the southeast and our pollen counts are already rising.  Oh joy.  I'm in AZ.

Have you recently moved, acquired pets, had a pet visit, changed laundry detergent, soap or shampoo?

Our dog we've had for almost a year. We've been in the same house for 7 years, and no change in anything.

I answered you in the bold!

[YouKnowWho]

Okay - more questions.

Has the dog shampoo changed?  Been recently boarded and possibly wiped down with something or bathed?

The reactions - are they happening after what you think might be the offending food?  (Make sure with the food diary that you are writing down brands and ingredient lists)

Bathroom questions - is he having any tummy issues (unexplained pain, diahreah, constipation, vomiting)  All the things that a 7yo is either proud to share or will look at you like you have a third head LOL

I ask because it seems like gluten also figures into this - did they run a blood test for Celiac? 

And because hives can most definitely be indicative of food allergies and his reactions seem to be sudden onset - did they prescribe an Epi-pen.  If your child is in school, make sure they understand that he has some inconclusive allergy issues and that he has an Epipen.  If you aren't already doing so, you may want to make sure that you are providing all food for him to cut down on possible reactions and be able to trace any future reactions.

[Frosted Crunch]

Okay - more questions.

Has the dog shampoo changed? The dog gets bathed every 2 months. He  just went in the 9th. Been recently boarded and possibly wiped down with something or bathed? Not that i'm aware of

The reactions - are they happening after what you think might be the offending food? I'm not sure, to be honest. I'm not with him all day, so i just have to take his word for it. (Make sure with the food diary that you are writing down brands and ingredient lists) Brands, i didn't even think of that, i'll start to add it.

Bathroom questions - is he having any tummy issues (unexplained pain, diahreah, constipation, vomiting)  All the things that a 7yo is either proud to share or will look at you like you have a third head LOL He hasn't complained of anything!

I ask because it seems like gluten also figures into this - did they run a blood test for Celiac?  They didn't.

And because hives can most definitely be indicative of food allergies and his reactions seem to be sudden onset - did they prescribe an Epi-pen. Yes. The pediatrician RX'd one, and then allergist did also (we have 2 right now)   If your child is in school, make sure they understand that he has some inconclusive allergy issues and that he has an Epipen. Oh yes, they're well aware. If you aren't already doing so, you may want to make sure that you are providing all food for him to cut down on possible reactions and be able to trace any future reactions. Yep. I pack some mean lunches

again, answered in bold!

[rebekahc]

Sounds like you're being pretty thorough so far and YKW has asked great questions and given you good suggestions!

I don't see on the testing where they tested for peanuts?  I would question an all-legume allergy since the soy was negative.  I'm pretty sure Cinnamon Toast Crunch has a peanut warning on it, I'm guessing the Frosted Toast Crunch might be the same?  On your food diary, I'd also suggest listing any may contain warnings, too.  My guess is that whatever triggered the initial reaction has just made him super sensitive/reactive for now and he may be reacting to things he's not really allergic to just because his body is primed to react, kwim?

Kudos to your doc for ONLY testing the suspected ingredients and not doing a huge panel of foods.    I would suggest calling the doc who did the testing and asking if RAST testing for those same ingredients plus other legumes and peanuts would be advisable to help narrow down the culprit.  Skin testing won't really be accurate if your DS has recently taken benadryl and steroids.  Our allergist wanted to wait 6 weeks after DD's big reaction to let the steroids fully get out of her system and allow her body to return to "normal" before she did skin testing.  I don't think the blood testing is affected, though.

One other thing, are the hives returning at somewhat predictable intervals?  When my DD and DS have had reactions, they end up getting hives for days - usually every few hours at first (as the dose of steroid starts to wear off) and then gradually further and further apart until they stop altogether.

I'm glad you found us, but really sorry your DS is having reactions!

[Frosted Crunch]

Sounds like you're being pretty thorough so far and YKW has asked great questions and given you good suggestions!

I don't see on the testing where they tested for peanuts? They tested for peanuts after this panel was done. So they didn't give me the paper sheet for that.  I would question an all-legume allergy since the soy was negative. ah yes, i forgot to mention his past soy history. My mom used to buy chocolate milk at costco and when costco would run out, she'd get the soy version of the same thing. Well Ds was having some random vomitings. It would ONLY be the chocolate milk coming up. It happened for a few weeks (like every 2 weeks when he'd have a sleep over) and i finally asked what kind of milk she was giving him. It turned out to be chocolate soy milk.  I'm pretty sure Cinnamon Toast Crunch has a peanut warning on it, I'm guessing the Frosted Toast Crunch might be the same? I don't see a warning. Just for wheat and soy. (nothing for peanuts)  On your food diary, I'd also suggest listing any may contain warnings, too. Ah yes, that's an excellent idea also!  My guess is that whatever triggered the initial reaction has just made him super sensitive/reactive for now and he may be reacting to things he's not really allergic to just because his body is primed to react, kwim?

Kinda, i'm so new to this whole thing.

Kudos to your doc for ONLY testing the suspected ingredients and not doing a huge panel of foods.    I would suggest calling the doc who did the testing and asking if RAST testing for those same ingredients plus other legumes and peanuts would be advisable to help narrow down the culprit.

You know, i called their office yesterday after the connection was made to light. I said about how the trees are both legume trees, and he stopped me from talking further, and said, 'well we'll see, as far as i know those trees only bloom in april-may, we'll just keep an eye on it.' He had to go before i could even say BUT HE'S EATING LEGUMES!!! Grr.

One other thing, are the hives returning at somewhat predictable intervals? 

At first they were. Every 4-6 hours when the benadryl would wear off. Now not so much, they just happen sporadically.


When my DD and DS have had reactions, they end up getting hives for days - usually every few hours at first (as the dose of steroid starts to wear off) and then gradually further and further apart until they stop altogether.

I'm glad you found us, but really sorry your DS is having reactions!

Me too! And i know, it's scary stuff. I'm glad you all have been so helpful!!

Answers in bold again!

[maeve]

I didn't see milk in the panel either.  I think you mentioned that it is a frosted cereal.  I'd have milk tested too.

[Frosted Crunch]

I didn't see milk in the panel either.  I think you mentioned that it is a frosted cereal.  I'd have milk tested too.

Yes, milk, Peanuts, and 2 others were in the second panel. He had the first set, and after they were done, the doc came in and added 4 more to it, to even out the top allergies.

[rebekahc]

Kudos to your doc for ONLY testing the suspected ingredients and not doing a huge panel of foods.    I would suggest calling the doc who did the testing and asking if RAST testing for those same ingredients plus other legumes and peanuts would be advisable to help narrow down the culprit. Skin testing won't really be accurate if your DS has recently taken benadryl and steroids.  Our allergist wanted to wait 6 weeks after DD's big reaction to let the steroids fully get out of her system and allow her body to return to "normal" before she did skin testing.  I don't think the blood testing is affected, though.

I edited my post and added the bolded part, but you had already quoted and were responding.  Didn't want you to miss it...

[YouKnowWho]

Also - keep in mind that shared lines and cross contamination warnings are entirely voluntary.  So while certain brands have that information, others do not.  So you will have to call ask if that information is not listed on certain brands (and some brands will fight and ask you for a doctor's note).

Did you have a skin prick test or a blood test.  My concern about a skin test would be a false result based on antihistimines being on board.

The prior soy milk connection is concerning.  If your allergist cut you off when trying to discuss the situation, that is concerning as well.  right now you are in a situation where you are grasping for straws trying to connect dots (and I don't mean that as a slight, I think most of us here have been there especially with mystery reactions) and the allergist needs to help piece those reactions together.  Silencing you or blowing you off is not the way to do it.

Does your son eat other legumes without issues - peas, beans, soybeans (not necessarily oil or lecithin), peanuts, etc?

[CMdeux]

I'm pretty sure Cinnamon Toast Crunch has a peanut warning on it


DD has eaten it on occasion-- no warning and she's super-sensitive, so it really does seem okay. 



Okay, might be time to investigate his school environment for any recent changes; new carpeting, new cleaner, new... well, new anything, I guess.

My DH was allergic to green beans as a kid.  He didn't develop a serious allergy to them until he was about six years old.  Just noting that.  It can happen.  In his case, it was probably secondary to his soy allergy, but it is possible that it might have been the other way around.  It's odd that soy would be completely negative in someone with any legume allergy.  Often it is falsely positive in anyone with any other legume allergy.  What other sources of soy has he eaten over the past year?  Asian food?  Prepared food (of any kind)?  I'll bet you that 90% of what is in your freezer and pantry has soy in it in some form... does he often complain of feeling bad or just seem "off" relative to other kids his age?  Those are big tip-offs for an allergy to a common and ubiquitous food. 

Also-- do know that tree pollens are quite different from the seed storage proteins which are common allergens in legumes.  So it's very very unlikely that a legume allergy (to a seed-storage protein) is responsible/related to the pollen allergies.

Has he eaten sesame in any kind of quantity?  Other seeds?  What were OTHER people eating during the meals and the superbowl party?  That oat skin test number seems a little out of line with the others.  Does he eat oatmeal?  Cheerios? 

What R said is true, but on the other hand, the above shows quite a robust reaction to the histamine control, so the results are probably accurate. 

Honestly, your timeline doesn't lead me to much aside from cinnamon or another spice/additive of some kind.  I'm not sure it's necessarily a food that you're looking for...     Sometimes it's tempting to look at foods and try to find correlations for reactions, but they aren't always there.  Environmental triggers can cause pretty severe reactions, as well.


You are correct-- this is quite the puzzle!!  I'm sorry that the answer isn't much more clear.   

[CMdeux]

His age would argue for the possibility of:

a) "non-pediatric" food allergy development.  Most kids who develop a FIRST food allergy at 6+ yo do so to shellfish, fish, or a tree nut.    That's anecdote, but there may actually be research data to back it up.

b) he's also of an age for severe environmental allergies to flare, perhaps for the first time.  Have you checked to see what pollens are spiking near you?  Has the weather contributed to high mold spores?  Has his classroom added a pet?  (Rodents are highly sensitizing, fwiw)  Do be thinking outside of the 'what has he eaten' box, and add as much detail as you can to that food diary, including other activities and their locations. 

[rebekahc]

I'm pretty sure Cinnamon Toast Crunch has a peanut warning on it


DD has eaten it on occasion-- no warning and she's super-sensitive, so it really does seem okay. 

I was thinking it was pretty recent because they came out with a PB variety??  Maybe I'm thinking of something else...



Hmm - don't see it listed on their website, though.