Fatal Reaction

[candyguru]

There are studies that found 86% and higher of kids diagnosed only by test results are not actually allergic.  I would want a food challenge for at least sesame since it is such a PITA to avoid.  My son can eat lentils and beans but is allergic to peanuts.  not sure the % of kids who are allergic to lentils who are also allergic to peanuts but if it is 50% of less I'd want to challenge that, too.

A food challenge is fine for some foods, but I can't imagine ever doing one for peanuts.  I am severely allergic to peanuts myself and react to airborne exposure (peanut dust) so would never want to do a food challenge with peanuts for my kids due to the potential severe reaction that may follow. 

It may be 86% inaccurate, but the positive skin test to eggs proved to be very accurate after she was exposed this summer and had a major reaction, so it seems my kids may be the exception with skin testing and actually have accurate results...  a food challenge is something I am hesitant to do after having been to the emergency room 4 times with my 6 yr old and twice with my 3 yr old.... just want to stay away from hospitals as much as we can these days.

My kids are very allergy prone.. my 6 yr old is currently having ragweed pollen allergy and is taking 2.5 ml to 5 ml of liquid cetirizine daily (Costco brand).

[CMdeux]

Honestly-- if you are one of the unfortunate 5% with seeming cross-reactivity/panallergen reactivity to legumes, it's probably better to just let it go.

   Lentil, lupine, and peanut allergies are VERY closely linked.  (Can't remember the source on that one, but it was a European journal.)

The only other grouping that I know of like that is in mammalian milks, or the cashew-pistachio-mango cluster.

[lakeswimr]

I can understand being hesitant.  Our allergist wants us to challenge all nuts and I'm dragging my feet.  But I know that people can have severe reactions to any food.  I'm somehow now scared to challenge other foods but 'nuts' makes it feel scary to me.

I don't know much about cross reactivity of peanuts with lentils so I can't say what I would do in your situation.

My child was having mystery reactions and in the process of tracking down the cause he tested hugely (and thankfully falsely) positive to a few things.  And all his other skin testing seems accurate, so I think that kids who test accurately to some foods can still have false positives.  Have you ever done a food challenge?  I thought they were super scary until we did some.  Other than for something peanut/nut-like I don't feel scared of them now. 

I know people who have kids who are MFA and super sensitive and react to ultra trace amounts and who feel they are airborne and who went to get tested at National Jewish and were found not allergic to tons of foods that had been diagnosed by a large panel test done by a non-allergist.  They were diagnosed to something like 50 foods when they were only allergic to a fraction of those foods. 

I understand what you are saying, though.  I would probably feel the same. 

[hk]

There are studies that found 86% and higher of kids diagnosed only by test results are not actually allergic.  I would want a food challenge for at least sesame since it is such a PITA to avoid.  My son can eat lentils and beans but is allergic to peanuts.  not sure the % of kids who are allergic to lentils who are also allergic to peanuts but if it is 50% of less I'd want to challenge that, too.

Sesame is the only thing we avoid due to test results only.  Allergist won't do a challenge because her RAST for it is over 7.  He is says sesame is such a potent allergen and won't risk it.  We don't have many great allergists on the west coast, but I will take her to national Jewish in CO if she will ever agree to a challenge.  Sesame is the one that impacts our life the most.  That said, she always hated the smell of it and refused to eat anything with sesame so she could very well be truly allergic to it.

[SilverLining]

There are studies that found 86% and higher of kids diagnosed only by test results are not actually allergic.  I would want a food challenge for at least sesame since it is such a PITA to avoid.  My son can eat lentils and beans but is allergic to peanuts.  not sure the % of kids who are allergic to lentils who are also allergic to peanuts but if it is 50% of less I'd want to challenge that, too.

Sesame is the only thing we avoid due to test results only.  Allergist won't do a challenge because her RAST for it is over 7.  He is says sesame is such a potent allergen and won't risk it.  We don't have many great allergists on the west coast, but I will take her to national Jewish in CO if she will ever agree to a challenge.  Sesame is the one that impacts our life the most.  That said, she always hated the smell of it and refused to eat anything with sesame so she could very well be truly allergic to it.

I'm one of those who actually liked the foods I'm allergic to.  But I truly believe you should trust your child's instincts.  She hates the smell and refuses to eat it TO ME that is a bigger sign of an allergy then a spt.  (That's my opinion based on seeing it with so many other people.  I have no links to prove it.) how many people even know what a sesame seed smells like?  I think it's a minor reaction.  (Again, just my own opinion.)

[maeve]

Erik so you are avoiding peanuts, eggs, sesame and tn bases in skin tests alone?  They have a high rate of false positives.  I would also have the ImmunoCAP test run for those to see if you also see positives there. 

We were in the same situation as candyguru. Sort of, DD was SPT after a reaction to egg, so we knew that one would be positive. From SPT testing, DD turned out to really have only two false positives, sesame and soy.  Soy was cross-reactivity in the testing because her peanut levels were so high. I don't think she was ever allergic to sesame, and she passed a food challenge at 8 to sesame.

[SilverLining]

Interview with Natalie's parents.

http://m.kcra.com/news/parents-of-girl-who-died-of-peanut-allergy-reaction-speak-out/-/17404292/21686610/-/wl8hmwz/-/index.html

I didn't know she had a twin.  That must be so devastating.  It's always hard to lose a sibling, but a twin is usually so much closer.

[my3guys]

Ok that was a tear jerker.  I'm in awe of the Giorgis' composure and I so appreciate what they're trying to do. One of my twins has MFA, the other doesn't. My heart breaks for the twin left behind.

[CMdeux]

Indeed.  As I suspected, the family indicates that they really did do everything that MOST of us would.  They even knew enough to limit her activity and observe her closely in spite of a lack of symptoms. 

The comments section, however, just boggles my mind.

 How can ANYONE possibly respond to that with "peanut allergies are mostly psychosomatic though"??  <--- 

[becca]

 

[twinturbo]

I had to seal my mouth shut yesterday when the allergist kept insisting there's no way a reaction will be missed and that there's going to be plenty of warning and time to use an EpiPen. Strange thing was I was only asking for an EAP and not this incident.

  Me grammar not so good. Ugh.

[ajasfolks2]

May just be a different link to same interview, but wanted to tuck this in here:

http://sacramento.cbslocal.com/2013/08/28/teens-parents-hope-peanut-allergy-death-brings-awareness/

[ajasfolks2]

Link to podcast  -- radio show in Sac area that friends and family have mentioned to me. . .


Link is embedded in this blog post (couldn't find just the link itself that would work):


http://www.gratefulfoodie.com/parents-of-teen-lost-to-peanut-death-speak-out/

[twinturbo]

"Lessons From a Teen Food Allergy Tragedy"
http://allergicliving.com/index.php/2013/08/22/lessons-from-a-teen-food-allergy-tragedy/?page=1

After finally reading this in whole it leaves me in an incredibly uncomfortable grey area on "minor" reactions. The difference of opinion between Canadian and American doctors was quite stark.

[CMdeux]

Seems to me, also, that anyone that has such a low threshold that they have reacted severely to environmental/occult exposure (probably inhalation or possibly hand-to-mucous membrane exposure) is also living life in a grey area the size of the Grand Canyon.

"Ingestion" is always a possibility.  Everywhere, all the time.

If I think about that too hard, it terrifies me.  But there is no way around it; every reaction could be "the big one" and I don't need to have a known source of ANY exposure/ingestion to pin it on.

That, too, changes management decisions.     I sure wish it were easier.