Questions about Allergy Test Results and Food Challenge

happygolucky0505

Hi, Ladies, I'm new to this board. I have a 3yo DD who was diagnosed with dairy allergy at approximately 4 months. I had a couple of questions that I was hoping to get some feedback on from other allergy mamas.

 First, we just had our first blood test (we have been relying on her reaction to the dairy and skin (scratch tests) up until now) and her IgE levels for dairy came back at 0, yay!  But, then, during the same visit we got our results, she failed the skin (scratch) test miserably.  So, we are headed back in a few weeks to do the food challenge. I was wondering how  many of you have had a kid fail one of the tests and pass the other and still fail the food challenge and what has your doctor told you about conflicting test results.

Second, are there any good kid books out there to help explain the food challenge?  Our doctor's  office will stop the challenge (and fail you) if the patient refuses the food for any reason. With a stubborn 3 year old, I worry that she will say no, just to say no and we will be sent home, even though the milk isn't bothering her.....  So, I wanted to prep her to let her know it's ok to say no if the food is making her sick, but otherwise, she should cooperate with the doctor.

 Finally,for the food challenge, we bring our own food.  I need to ask the doctor, but wondering if it has to be the same food for the whole challenge, or if I can bring different things, like milk, ice cream, cheese for to try different things along the way (4 long hours that I'm dreading...).

Thanks in advance!!!!

mrsmac08

I don't know if this helps. But my twins, DD and DS  have non-IgE mediated allergies to Dairy and to Soy, respectively. So, they get negative results from both blood and skin tests. There is no way to test non-IgE mediated reactions. We challenged DD at 9 months, and she failed the challenge. We didn't challenge DS with soy, but gave him soy-based products before we were sure it was an allergy and he threw up, and during that time period had some eye and skin irritations. 

We believe DS is also allergic to peanuts, and he passed the skin test for it. However, when he tried a miniscule amount of pb, he got a hive and threw up a ton.  The allergist believes it is IgE mediated and could not fully explain why he didn't react to the skin test...but basically just believes that reactions can sometimes vary. I'm not sure if we will challenge with pb, that's a discussion that we still need to have with the allergist.

 When we challenged DD, we did it in a slow progression.  She has delayed reactions and we were at the doctor's office for 3 hours. She did not have a reaction until we got home.  Her reaction is gastrointestinal, and she suddenly vomits all stomach contents and basically goes limp, and can't hold anything down for hours. We have a new pediatric allergist and will do all future challenges in a hospital setting, likely with DD hooked to an IV (we aren't sure about DS, because his reaction is typically less severe). He said that they won't do a progression (this may only be with the delayed onset, I'm not sure), they give the child what a normal serving would be for them (I assume we will try milk, but since she doesn't drink a lot of rice milk, I'm thinking we'll probably have to try adding cheese and yogurt, as if she was eating all of these things at one meal.)

Good luck!!

 

Christine&Mario

GL!

I can't help you with all of your questions since DD is younger; she is 7 months old and we did a soy formula challenge after her RAST came back at a 0 and her scratch test was "iffy". She did not have a reaction in the office but developed a bleeding diaper rash (not that she had blood in her stool, but that her actual skin was rashed and bleeding) that started about 12 hours after the challenge and got worse throughout the day. So, the whole experience ended up being frustrating because we "passed" the challenge but got a vague "intolerance or something like that" label after the fact. The doctor did not give her an official allergy dx, but I'm essentially treating it as such and he recommended pulling it from her diet.

Not sure about the books, or bringing several types of food, but I imagine it would be fine to bring a few different things as long as you aren't introducing extra potential allergens (ie, if you are testing for a dairy allergy don't bring an ice cream with nuts or soy in it). But, you'd have to ask.

You will get through it! Just bring plenty of activities - do you have an iPad or some other device where you guys could watch some movies or something? The whole experience will likely be boring and tedious more than anything else.

happygolucky0505

Thanks to both of you!!!  That's really helpful info.  I agree, the test will be more tedious than anything, but we will endure it! Fortunately, I just found two the presents I bought for her for her birthday and then promptly lost, so I will introduce those that day!

 And thanks for the info on the non-IgE mediated allergy.  I did some reading on it and even if we have that, it would take a great burden off my mind since it is rarely, if ever, an anaphalactic reaction.  I feel for all the moms who have to send their kids to school with a life threatening allergy like that!

heyitsme

happygolucky0505:

I was wondering how  many of you have had a kid fail one of the tests and pass the other and still fail the food challenge and what has your doctor told you about conflicting test results.

 Not my child, but me. I'm a strange anomaly (LOL). I test negative to ALL the things I'm allergic to when blood tested (RAST and Immunocap). But then comes the SPTs and I have huge wheals to them all. I've challenged some of them, but others I just eliminate without opting for a challenge (because I've reacted to them in the past). Reaction trumps results is what my allergist always says. So if she passes a food trial, then my allergist would say she's in the clear. If you have sensitive skin, it can throw off SPTs, especially if you are prone to eczema.

And for the trials, my doctor always required the item being tested in its purest form (so milk, not cheese or anything just containing milk; just eggs, etc.). You may want to inquire if they're going to do a "baked milk" challenge as well, though (some people can eat baked-in milk but not straight milk).