new RAST results

[fluffy]

We just received the results of the DD's test this afternoon and I must say, I'm mighty confused. 

Last year the results were: egg--1.11, peanut--.97, cashew--3.31

This year's results:  egg--2.76, peanut--1.02, cashew--2.87. 

We also did milk this year and it was 55.8.  Not sure why we didn't test last year. She's had multiple ana reactions to milk, so this was no big surprise.  Although, it was a little weird seeing a number value placed on it. 

I guess the question that I have is about the egg.  It more than doubled.  Is that normal?   

And the peanut being so low makes no sense to me.  She's reacted to the smell of peanuts more than once (hives and coughing). 

And really, what does this say about the chances of her growing out of this?  She turns 5 soon.  It seems like a lot of kiddos outgrow by 5. 


I guess nothing really has changed.  We're not going to change our lives or anything.  We already have all the precautions in place.  We're getting pretty used to this stuff after 3 years.     I'm not sure how much energy and focus I should really give this, but I'm surprisingly blue about it.

[CMdeux]

I guess the question that I have is about the egg.  It more than doubled.  Is that normal?   

It depends on the age of the child in question...

She turns 5 soon.  It seems like a lot of kiddos outgrow by 5. 

Well, there you go.  "A lot" of kids (ie-- 'most' as it happens, at least in this particular age cohort) do NOT outgrow by five anymore...

and those who are MFA are even LESS likely to be in that group, on average... and--

they tend to have RAST SCORES WHICH PEAK AT 4-6YO.

Oh, and anaphylaxis is pretty much the thing that (at least anecdotally) tends to suggest that an allergy is more and more likely to be lifelong-- or at least to be highly persistent.  I personally have begun to suspect that kids that anaphylax to an allergen probably won't EVER be able to truly have normal tolerance to it... might be able to increase the threshold to the point where they tolerate "like normal" servings of it, even... but their immune systems still haven't really forgotten.  (KWIM?)   That's where my DD is with milk now, and where I am with egg. 

As far as the peanut number being so low... um... this just (really, really, in your case) proves the point that reaction history trumps the numbers every day of the week and twice on Sunday.

Sorry that nothing much seems to have changed for the better.  <sigh> I know that lots of us have been there at that age.  We haven't bothered doing any RAST values since DD was about eight, and this is a big reason why.  It was just too hard to keep hoping-- for nothing.

It really feels like a punch to the gut to get those numbers back and find that nothing is different.   

[fluffy]

CMdeux,

Thank you so much for taking the time to answer. You always have such thoughtful responses.It is appreciated. 

It's good to know that the numbers peak at this age. I wish the allergist would have said that to me.  She keeps beating the "let's hope she grows out of some of these before kindergarten" drum.  I think it's unrealistic and overly optimistic.  And I let her get my hopes up.   Drat.

I think you've confirmed a lot of the things that I've been feeling in my gut.

[joanna5]

Our experience was like CM2 said- David's peaked at around 5-6 years old.  His numbers have all gone down some now at almost 8, but nothing we can challenge any time soon.  Every year we hope, every year I cry.  And then we move on and keep on doing what we were doing. 

I'm sorry you didn't get better news. 

[hopechap]

Did you use the same lab?  My kid's numbers were varied when our insurance dropped one lab and went with LabCorp.  the drs in my practice indicated that they do not like LabCorp.

I don't mean to give you even MORE false hope, but different labs could account for some of the variability.


And I hate it when numbers go up too. One wants to feel like there is progress. But maybe, the numbers don't mean a great deal, really within a certain range.

[fluffy]

Hopechap,
I'm not sure if they used the same lab or not.  We have to take it at our local hospital and they send out the lab from there.  I know the allergist requested that they use the same lab, but who know what they actually did.

I wonder if that's the difference.  hmmm....

Wondering too if the difference is just an acceptable variance.  They're not huge numbers.  What's the margin of error, KWIM?

I'm trying to keep some perspective on this.  We are in a much, much better place this year than a couple of years ago and I want to be thankful for that. 

[rebekahc]

There's also the negative predictive value and positive predictive value to consider as well.  What those mean are:

NPV - people with ku/l below a certain value have a 95% chance of NOT being allergic
PPV - people with ku/l above a certain value have a 95% chance of being allergic

The actual numbers vary by allergen, but here's a quick and easy slide show I found that explains it and has a chart of the values for several allergens (about half way through). http://www.phoenixallergynetwork.org/uploads/2/7/6/5/2765509/pan_-dr._keahey_presentation.pdf

People with ku/l between the NPV and PPV are somewhere in between on their chances of being allergic.  Your DD's numbers both last year and this year for egg and peanut are between the NPV and PPV and tend to be in the same general range between the two values, so I'm thinking the change in number probably isn't as significant as it might seem.  I think her reaction history is probably more indicative of her chances of outgrowing than any fluctuation in number.

The best test for determining your DD's chance of outgrowing would be component testing.  I know it's available for peanut, but I don't think so for egg yet.  However, her low ku/l for egg might indicate she's a good candidate to tolerate cooked egg - that could be something to explore.

It seems your doctor is giving the old advice that kids outgrow by a certain age.  It's unfair for her to raise your hopes based on old wisdom and not taking current knowledge, new testing methods and your DD's individual history into account.
   

[bleh]

My daughter tested negative for eggs recently so we had an egg challenge and failed. I basically stopped worrying about the test numbers.