Peanut/nut allergies getting worse

[Lima1]

Hi, I was just in hopsital this morning getting DS's yearly allergy tests done. He had a good few food allergies when he was a baby (he is just gone 3 yrs old) and thankfully has outgrown most, the last being milk last year. That only left egg and peanut and possibly tree nuts - he had not previously been tetsted for tree nut but I was told to avoid.
Last year his SPT was 5mm for egg and 4mm for peanut, RAST was 47 for egg and 27 for peanut (this peanut was up from 17 the previous year).

This morning I met with the dietician before the tests and she said hopefully he would only need the SPT and it would be negative for egg and peanut and she suggested to test for tree nuts and hopefully that would be negative (ie under 3mm). She was confident that he was outgrowing them all and we could start challenges.

His results from the SPT today were
egg - 5mm - possibly 6mm
peanut - 7mm
cashew - 6mm
hazelnut and brazil - 7mm
almond - 8mm (it was actually 8.5 but she put down 8)

The nurse was very surprised and she rang the dietician who said she was shocked they were so high. So he was sent for RAST which ill get the results off in a couple of weeks and she will call me then.

I am very disappointed as the egg is the same or possibly worse, it had come down every year to date.
The peanut is really worrying me, it has gone from 4mm to 7mm in a year.
I spoke with the dietician during the year about epipens (ds doesnt have one) and she said because he didnt have issues with breathing and SPT were below 8mm he didnt need it.
Now his results are heading towards 8mm, almond is 8mm.
I know ill have to wait for the RAST to get the true picture but im starting to panic now.

My question is for those of you with LO with bad peanut or tree nut allergies is, is this normal to jump like this in a year. Im worried they will keep rising.
I was never concerned about his peanut allergy as no one else seemed to be. I dont give him foods with nuts in them but I have been giving foods which say "may contain traces" such as Cheerios breakfast cereal or chocolate and he is fine. The nurse today told me to stop that now.

I know many of you on here know a good deal about allergies so I was wondering if any of you know if reactions stay the same. DS's allergic reactions to milk and egg have been skin reactions - hives and eczema and blotching. Is it possible that he could have a respiratory reaction to nuts even if his other reactions have been skin based?
I do intend on asking the dietician all this when I talk to her but ill be worried sick for the next 2 weeks and I know if I ask her know she will just tell me to wait for the results - she wont want to commit to answers.

Many thanks.

[ukey]

Its very unlikely that he will outgrow nut allergies,

have you looked at the NICE guidelines?

[eragon]

sounds very familier to me, and my son did grow out of all but one of his tree nut allergies, but has higher rateing to peanut.
As a multiple allergic child outgrowing to all doesnt often work that way,certainly after 7 yrs peanut is considered life long.

i wouldnt stress too much on ratings, daily life doesnt change any, and if any outgrowing happens, thats a bonus.

[ukey]

no one can predict how severe an allergy will be, though there is a new test available now 'component testing' I think its called which can predict if a child is more likely to have an anaphylactic reaction.

[Bookwolf32]

I am allergic to nuts - mainly peanuts and tree nuts, but thankfully not anaphylactic. As a child my allergy meant that if I ingested nuts I threw up and came up in hives. If I directly touched nuts i would come up in hives too, but fairly mildly. I soon learnt to avoid all nuts and anything containing nuts - Although I've never needed to avoid things saying may contain nuts. As an adult I started making a flapjack type bar for my partner that contained nuts, I was barely touching the nuts and always washed my hands carefully afterwards. Eventually I started getting severe eczema, initially had no idea what was causing it. After 9 months I was eventually tested for a bunch of allergies and the nuts came up as quite high, so I got rid of all nuts in the house and banned my partner from having nuts and within a week all eczema had gone. What I'm trying to illustrate in a rambling way is that allergies can change, but I think if you are allergic to nuts it won't go away and repeated exposure can increase the severity of reaction.

[eragon]

i always find it useful to remember these :
factors that increase the probilbilty of going from a mild reaction to full blown anaphylaxis

amount ingested.
health at time of allergen ingested , recovering from a virus or infection or other illness
alchohol (speeds up digestion)
hormone ( womans time of month)
asthma control
time of year. ( body reacting to envio allergies for instance)
exercise ( again speeds up reaction)
stress ( high stress eg exam stress)

Each exposure is different and may vary every time.

ezcema or hives etc that are resolved are not proof of a mild allergy.

unless an immunologist as advised differently and for some this is the case, the majority of people with history of reactions and high test results are considered allergic and at risk of anaphylaxis.

So no one can predict how severe a reaction may be at the time,due to above factors.

my son has had many many reactions to the foods he is allergic two, and has had only three anaphylaxtic episodes. He is considered a low risk because he is not an asthmatic, but still needs his auto injecters with him at all times.

He has outgrown some, but is still an allergic person and always will be, there are worse conditions out there, its our strange norm, and as he will be 17 soon, it will be his own strange norm. iyswim!

[Lima1]

Thanks so much for your replies. I'm in

[Lima1]

Sorry posted above by accident. I was going to say i'm in Ireland and we don't seem to have the same advanced allergy care here as you do in UK. My ds attends one of the country's main childrens hospitals and they were suggesting last year that ds be transferred to the care of a specialist in Cork, which will be a 4 hr drive each way for us.

I'm just afraid of him being exposed to something and having a bad reaction and us not being equipped to deal with it.
There was a report on our local radio that said if an ambulance was needed in my area it would take at least 45 mins to arrive. I'm also 45 mins from the nearest hospital.

I'm not the type to overreact but I want to make sure I'm doing what my ds needs. I would prefer to be prepared for any eventuality.

That component test sounds interesting, I'll ask about it when I'm getting the results.
Thanks again.

[Lima1]

Eragon- what would be considered high results, generally speaking. Would that be SPT results in double figures and RAST around 100?

[eragon]

Yes, i think so, my son has had high spt, and that trail that follows the vein up his arm. His doc said 'avoid peanut like the plague' . which when a allergy doc says that you understand its high, but really the peanut is reasonably easy to avoid compared to the others.

As you live some way from getting medical help, how many auto injectors do you have?

we have travelled e.g long haul flights and so planned a large supply just in case, I would do the same if we traveled to remote places away from hosptial back up.
I am aware that Ireland and Scotland have a pretty poor allergy service, and I would try and travel to see that rare creature the pead immunologist! At least once you are under their care you can ring them for advice if needed.

life doenst change just because a food allergy has a high rating, you still avoid just like the other allergies on list. So in a way life doesnt change, but still carries on. On a bad day(that we all have) it helps to remember that the days without a reaction are many, which shows you are managing this problem well.

[Lima1]

Thanks eragon. We don't have any auto injectors. I asked last year if he needed them and I was told no. The reason being that he doesn't have asthma, has not had issues with breathing when having a reaction. I was told that if the SPT was 8mm then in even in the absence of asthma/breathing issues it would be looked at. At that time SPT was 5mm for egg and 4 mm for peanut, no tests for tree nuts had been done at that stage. I was satisfied with that as he had only minor reactions to egg. For example I was eating a tea cake and holding him on my knee, he leaned forward and took a nibble. Literally when I realised what he had done I turned him around to take it out of his mouth but he was already spitting it out. Immediately he broke out in small hives around his mouth, it must have been itchy because he kept pulling at his mouth and sticking his tongue out. I have Piriton and hives were gone in about 15/20 mins. That would be a normal reaction to egg.
Regarding nuts he has never eaten them but I would have eaten them in the house and just washed my hands and brushed my teeth afterwards and make sure he doesn't use any of the utensils we have used. Same if any of us eat egg (which is rare).

I don't want to go in demanding auto injectors if he doesn't need them, I totally understand that on the scale of seriousness many children are alot worse and we are luckly, but I'm conscious of not underestimating the seriousness of it either especially seeing as they can't tell what type of reaction he MAY have if exposed.
The tree nuts allergy is worrying me because I think if people are asked if the food contains nuts they automatically think of peanuts but may for example overlook almonds. Maybe I'm worrying too much.

[neolara]

Blimey. I've got to say that if my child reacted like that, I would definitely be asked for epipens/ jext. As eragon said further upthread, reactions are affected by all sorts of things. I think it would be wise to be prepared for all eventualities.

[eragon]

I have to say i agree with neolara. you could try and give the anaphylaxis campaign help line a ring for advice, and see if they are aware of any other immunologists nearer to you.

[ukey]

perhaps you should try going to see the other allergist in cork if it means they would do further investigation, better advice and epi pens?

P.S we r in Scotland I wouldn't say the allergy service in my area was any better or worse than anywhere else? perhaps in certain areas of Scotland the allergy advice and service is poor??

[Lima1]

I will definitely ask to be seen by the specialist in Cork. I am also going to ring Anaphalysix Uk and ask their advice too. I'll take a look at the NICE guidelines at lunch when I put the kids down for a nap.
Thanks again to everyone.

[girlsyearapart]

Hi

We also had the same experience this year. Dds skin prick results all went up.

For example her peanut & her sesame almost doubled to 15mm this year.
We were told that it is because her allergies are growing with her rather than her growing out of them.

Also told that she is highly unlikely to ever grow out of the nut & sesame allergies although likely to grow out of the egg allergy. (10mm for egg atm)

Fwiw we do have epipens & have used 3 times

[Lima1]

Oh God Girlsyearapart that's terrible. That's my fear is that they will grow every year. Just to make sure I understand you correctly was her peanut about 7mm then last year?
Can I also ask what was the criteria used when prescribing the epipens and what were the reactions to?

On Friday DS had a reaction to egg. My sister made a shepards pie and I gave a small bowl of it to ds. She used a packet mix for the mince that I always use. He ate a tiny spoonful and startec sort of smacking his lips. He didn't want anymore but I kept coaxing him because he lives shepards pie. I got a second tiny spoonful into him and then he clamped his mouth shut and wouldn't even talk to me. At this point his strange behaviour made me think maybe there is something in it. I checked the packet and it said "contains traces of egg", it wasn't even enough that it was listed in the ingredients. I went back to him and by now he has spots around his mouth and chin and one about 7mm I'm size on his lower back with a large red ring around it. His cheeks were hot and flushed. I have him 2.5mls of antihistimane.
A few mins later I asked him a question and his voice sounded very slurred and low. I completely freaked out, I was panicking that his tongue was swelling. Thankfully it wasn't but I was in a heap crying.

I know the reaction was mild but I can't even imagine the tiny trace amount he must have eaten. The amount of meat was about the size of your thumbnail and the packet mix had been added to 1.5lb of mince and the packet only contain a trace of egg which would have been in the most processed form.
I am really shocked he is reacting to such small amounts, I can't imagine what would happens if he actually ate some egg.