Sooo. DD2 apparently has a level 2 peanut allergy

[Schulte]

I knew she was allergic to eggs, which also came back as level 2 in the RAST test, but the peanut is new. Obviously she's never had peanuts (she's 2 1/2) and she's also never eaten egg - just reacted on skin contact. Can anyone explain what this 'level 2' actually means? Especially with regards to her egg allergy - might she be okay with well cooked egg yet? Or do you have to have a lower RAST before considering a cake challenge?

PS consultant happily prescribed epipen for the peanut allergy... at least we'll have it to hand should we ever need it.

Anyone please? I just read on another thread that they had an egg challenge with a RAST level 3 result?

Please can someone come along and help me understand these RAST results?

Bumping for Schulte

oooh you have piqued my interest

dd age 4 is allergic to peanuts, she had a skin prick type test and came up in a welt at an allergy clinic after referral by our gp

No one called it a RAST test, or gave us a level - in fact they said it wasn't possible to know how severe her allergy was!

now i am really confused - what is a RAST and how can you know how severe an allergy ie?

Hiya the levels just been how 'likely' your child will be to react to the allergen again. My daughter is level 4 and had a bad but not severe reaction to a trace of peanut. A level 2 means your child will 'probably' react I would think. The levels do not indicate severity so you won't know if your daughter will react mildly or severely to a peanut unfortunately. I don't know how accurate the tests are though if your daughter has never come into contact with a peanut....

The RAST tests are another word for the blood tests I think. I'm new to all this but picking stuff up along the way! I think the skin prick tests are something different again...

Hope someone else can clear this up for you both!

• mean not been!

Oh and there is no way of knowing how severe or mild a reaction can be - especially with a nut allergy. One of those things unfortunately.

Oh that's interesting kerrymumbles, my daughter came back level 2 for seafood, but not sure what's she's allergic too... never reacted to anything that we know of.

my ds has a peanut allergy too, he had the skin prick test and got perscriped epipens and antihistamine (sp), never heard of rast.

The RAST test is the blood test where they measure levels of IgE in the blood. That's interesting that kerrymumble's son can eat some things that he has had a level 2 result for. For those of you with peanut allergic children, I'd be interested to hear if they eat other nuts without problems? Consultant said to avoid all nuts although she showed no allergy to tree nuts, it's just a precaution I think so interested to hear what other people do about other nuts. I personally am allergic to tree nuts (not anaphylactic) but can eat peanuts, but again was told to better avoid them just in case.

Lilpickle - when you say your dd reacted to a trace of peanuts - do you mean the label on the food she ate said 'may contain traces of'? That would be my other question - do you really avoid foods that say may contain traces of? As I said I am allergic to hazelnuts, pecans, cashews but have only ever avoided foods that had those in the ingredients list. Avoiding everything that says 'traces of' would be a real pain, I imagine!

Hiya

Sorry Schulte when I said 'trace', my daughter ate a chocolate shaving from my cereal which I realised after the allergic reaction contained peanuts - so whilst she didn't eat a peanut, she probably had a little crumb or something on the chocolate.

She tested negative to tree nuts so the consultant told us to tread carefully with other nuts but that she could have them! I'm still unsure whether we want to give her them though to be honest - still waiting for a referral to the specialist allergy clinic so will see what they say. The consultant said it was difficult to avoid 'may contain traces' and to just give her anything like that as the risk was 'minimal'. Again still not sure about that! Saying that she has eaten Nutella without a problem in the past so we might start her off on that.

It's a minefield though with all the different information and opinions about! By the way my daughter used to be very allergic to egg but can now eat it in cooked form - ie cakes. She can also now touch raw egg which she never used to be able to do so it means we can do baking together now :-)

Oh and also I believe that the proteins found in egg and peanut are very similar, hence a lot of egg allergic children are peanut allergic...

DS2 has had RASTs done and, amongst other things, has a score of 100 for peanuts. He has a high score for a variety of other nuts too. We were never told a level, just a number out of 100, withanything over 17 meaning an allergy.

We don't avoid 'may contain' but this is against his consultant's advice. So far he has not had a reaction to may contain, but we'd probably rethink it if he did. It's a personal choice. To exclude everything he's allergic to including may contain, would limit his diet horribly as he's allergic to so many foods.

We've been told his scores have to drop significantly before they'll even consider a food challenge.

For those that are interested this is the RAST scale:

100.00 : ALLERGEN LEVEL 6 - EXTREMELY HIGH LEVEL OF ALLERGEN SPECIFIC IgE

None of this indicates severity though, it only indicates 'likelihood' of reaction apparently.

Really, under 17 KU/l you're not officially considered allergic?

Oh - Lilpickle when did your dd grow out of her egg allergy?

I'm surprised at the 17 KU/l thing - given that it falls in the 'high level' category. Not sure that's right Schulte - but we all seem to get different advice!

My DD is still growing out of her egg allergy. Under 1 she couldn't tolerate it at all, by 2 she could tolerate it cooked in things like cake and by 3 she could tolerate touching raw egg but she still can't eat it on it's own - ie scrambled egg or egg sandwiches.

Thanks Lilpickle. Yes it's confusing, all that conflicting advice - always depends on who you see. Our consultant is just a paed, not even an allergy specialist. He said he wouldn't retest until in 2 years' time, but I would really like to know if DD is starting to grow out of her egg allergy - she's 2 1/2 after all - it would be good if she could eat cake. How did you find out about your DD tolerating cooked egg, did she have a challenge?

If you're in the UK, Schulte, you could call the Anaphylaxis Campaign helpline for advice on how to interpret the tests. As far as I'm aware, the 'gold standard' for food allergy diagnosis is a food challenge but these should be done in specialist units, which can be a problem in the NHS as specialist allergy units are a bit scarce, so long waits. Did your consultant mention a challenge for the peanut? Fyi this US based paediatrician writes about the food allergy guidelines which were published in US in 2010, which advise against making a diagnosis based purely on skin or RAST tests.

Hi - I was told they considered over 17 an allergic result, but that does seem totally wrong when I look at the bands above! I'll ask for more information when we go in next. They do seem reluctant to actually let me see anything. It's all just numbers read out over the phone, very frustrating.

I second what ClaireOB has said re food challenges. It's absolutely the only sure test. Mind you, DS2 is now nearly 4 and we've only managed to get one challenge done.

Thanks everyone, that's really helpful. I will try that helpline. A friend also gave me the number of an allergy specialist near here yesterday so I might go see him privately.

Good luck with it all and let us know how you get on. Meanwhile fyi, that US based allergist I linked to up thread has posted again yesterday about food allergy diagnosis and the need to confirm by oral challenge.

That's an interesting link, ClaireOB.

DS had RAST tests when he was about 13 months old. He had a 'score' of 3.0 to wheat and 3.5 to soya but he can eat both wheat and soya with no problems (and was already eating wheat most days when he was tested).

He has had fairly major reactions to eggs and dairy, and his RAST scores for those were 60-something and 80-something... The allergy doctor said there was no point putting him through further tests for a few years yet, as the tests would certainly not tell us anything we didn't already know!

His result for peanuts was only 3.5, but we were told to avoid all nuts as his result for tree nuts was higher (although still only about 8.5). Worth noting that he has never been exposed to any nuts as far as I know - even when I was pregnant with him. Also that he is allergic to pulses (related to possible peanut allergy?)

Schulte, I hope you get some really good advice from the anaphylaxis campaign. The whole issue of allergy testing is so confusing!