Peanut Allergy - testing question

Tatstar

I posted here once a few months ago about suspecting DS has an egg allergy.  I fed him eggs twice and both times he got a few hives around his mouth.  The first time it happened he was snacking on a few things so I didn't realize it was eggs, so that's why he had them twice.  I talked to doctor and he suggested bloodwork and avoidance.  We have not fed him eggs since, but I have not been back for the bloodwork due to a rash of illness in our house. 

So last night, he had a bit of peanut butter from my husband's sandwich.  I don't think DH thought it was an issue and I wasn't paying attention to them.  15 minutes later, little man's entire face is bright red with hives and his right eye and mouth are swollen.  I FUH-REAKED out and tossed us all in the car to hit the ER.  His breathing was never affected (he did have a pretty nice sneezing attack) and it was clearing up by an hour later, but the hospital gave him a shot of benadryl and told us to get the bloodwork done ASAP.

I have an appt to take him in tomorrow morning, but here is my question:  If the pedi does their workup and it comes back postive, will they then refer us to an allergist for MORE testing?  I'm just curious as to how much the pedi can tell us from their basic testing - will they just say yes, he's allergic or can they give us severity levels?

 

la79al

The bloodwork will give you a number and you can see on this chart how severe the allergy is. 

RAST rating	IgE level (KU/L)	comment
0	< 0.35	ABSENT OR UNDETECTABLE ALLERGEN SPECIFIC IgE
1	0.35 - 0.69	LOW LEVEL OF ALLERGEN SPECIFIC IgE
2	0.70 - 3.49	MODERATE LEVEL OF ALLERGEN SPECIFIC IgE
3	3.50 - 17.49	HIGH LEVEL OF ALLERGEN SPECIFIC IgE
4	17.50 - 49.99	VERY HIGH LEVEL OF ALLERGEN SPECIFIC IgE
5	50.0 - 100.00	VERY HIGH LEVEL OF ALLERGEN SPECIFIC IgE
6	> 100.00	EXTREMELY HIGH LEVEL OF ALLERGEN SPECIFIC IgE

From what I understand, the level of severity does not determine the level of reaction, for example, even if your numbers come back and put you at a level 2, you should still talk to the doctor about an epipen because DS could still have a very bad reaction.  It seems to vary as far as which levels doctors will tell you to avoid.  Ours said anything level 3 and higher should be avoided but I know some mommas on here avoid level 1s because their kiddos have reactions.  It also seems to vary on further testing.  Our doctor did not give me the impression that she thought further testing was necessary but I am going to be making an appointment with an allergist and getting their opinion on further testing (I also have some questions that I would like to get answers to). 

magdusia

Tatstar:

I have an appt to take him in tomorrow morning, but here is my question:  If the pedi does their workup and it comes back postive, will they then refer us to an allergist for MORE testing?  I'm just curious as to how much the pedi can tell us from their basic testing - will they just say yes, he's allergic or can they give us severity levels?

I would ask the pedi to test your LO for at least the top 8 since she's going to draw blood anyways.  When we went to the ER we were told to go straight to the Allergist.. which we did. I don't think most pedis understand allergies so its better to go to an actual allergist instead.   HOnestly, even if everything comes out negative i would still go see an allergist. 

Your pedi will most likely just tell you what your LO is allergic to. You can request the levels.. but most will probably not offer it since they don't think you will understand them.  So you may have to request them. 

GOOD LUCK!

 

lindac1

When DD had her incident last year, I took her to her regular pedi.  He ordered the bloodwork, called us w/the results (yes, he had the level but as we have learned the severity level doesn't speak to the reaction level), wrote the script for the epi pen and then told me to take her to an allergist.  He said that while he had the results, and could tell us we needed to have the epi pen at all times, the allergist is the best person for us to talk to. 

He (pedi) basically said is not a specialist in this area and the allergist is better equipped to help us learn how to understand what it all means and how to live with the food allergies.

The allergist then took a thorough, complete history, tested her for a slew of other items (not blood tests, but the skin tests), and followed up with our pedi with a written overview of his testing and findings.  I appreciated the pedi telling us to see the allergist, and also like that the allergist includes the pedi in his findings.

Good luck!