Rast went from 12 to 2.6 in two years. Is that a level that can be challenged

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dlibby1angel:
On the day of the blood test our ds's allergist said he would consider a baked egg challenge if the result went from the 12 in 2010 result to a single digit, say a "6". Well it came back at 2.6! Upon calling us with that result, his nurse said the Dr. does not like to do a challenge until the number is less than 2.

We did ask for clarification and are waiting to hear back. What do think? Challenge-ready or not? I don't mind waiting but dh is wanting it to happen.

For what it's worth, all other rast numbers are up-some significantly enough to move from a class of "high" to "extreme."

maeve:
Are you talking a challenge for baked egg (which is really a dose setting challenge) or a challenge for egg itself?

My DD had a baked egg challenge at Hopkins a couple of years ago when her rast was between 12 and 9. Her dose during the challenge was set at 1/16 of an egg.

rebekahc:
They have determined positive and negative predictive values for egg. Of those who have a RAST value of 6 kU/L or higher, 95% will fail an egg challenge (actual egg - not low dose baked). Of those who have a RAST value of 0.6 or lower, 90% will pass an egg challenge. Your son falls somewhere between those, so it seems he would at least be a candidate for a baked egg challenge.

Did they skin test him, too? 50% of kids with skin test of 3mm passed oral challenges.

Here's a PDF with the info www.newenglandsocietyofallergy.org/Meeting%20PDFs/Young.pdf‎

Edited to fix child's gender :misspeak: Sorry!

CMdeux:
BUT-- low-dose baked (that is, a dose-setting challenge, which is what we did when my DD's RAST was still pretty high, around 8-9, I think) those numbers aren't really accurate, remember...

apparently the RAST has little correlation with who can pass those. Our allergist's anecdotal statement about that is that "around half"of people even with VERY high RAST values can tolerate baked egg.

maeve:
And yet at our last appointment at Hopkins we were told that they're finding in their practice that the egg allergic tolerate baked egg less well than the milk allergic tolerate baked milk.