sesame allergy

[Jemstone]

Just got back from having a food challenge with sesame at the hospital for my ds. Tried tahini but he spat the first lot out and was getting very aggressive and badly behaved. Finally managed with the help of the play specialist to get him to eat sesame snaps.

He failed at the end of the challenge with swollen eyes, a couple of hives under his eyes, an itchy throat and lots of scratching and snorting. He was given piriton and about 2 hours later the swelling finally went down, mood improved rapidly though!

My question is though when I got home my oh told me he'd given ds loratadine the night before as he was so uncomfty from environmental allergies. So how severe is ds allergy to sesame? During test although there were no concrete signs of reaction his behaviour was bad enough that the nurse was asking for my epipen and expecting it to have to be used.

I'd love to lose the epipen and was hoping the test would give me an answer but now I don't know. He didn't go into anaphylaxis and had 2 whole sesame snaps in total to get a reaction but given the antihistamine the night before I just don't know! Any advice?

Given the reaction you describe and the fact that he'd had anti-histamine the night before I would say that you need to take his allergy very seriously. The itchy throat is particularly worrying so I don't think you should dump the epi-pens just yet. Sorry

well, to be frank give up the idea of loosing the epi pen unless an immunologist says different.
Embrace the fact that epi pens are there to save your childs life when a reaction goes in to anaphylaxis.

it concerns me that you describe his reaction as a 'behaviour', his symptoms are not a choice he has to make.

The safest parental attitude is to view the epi pens as something you WILL use at some point.

your son is allergic , and quite severely to sesame. today was him eating a large amount with a significant reaction, when he was judged to be healthy.

understand your wish to loose them, its a big responsibilty.

Eragon, the problem was I think that the anti histamine my oh had given him the night before was masking symptoms so the behaviour was the only symptom for most of the challenge. We did consider it might have been a reaction but then again it might have just been because he was tired and in a hospital. He threw my lunch in the bin so I was not best pleased!

I think you're right though, we'll be keeping the epi pen and trying to convince the Gp to prescribe another 2 for after school club. I find the problem with sesame its it's normally ok to avoid (he's fine with may contain traces of, probably due to the amount of antihistamine he takes normally) but people don't realise houmous its one of the worst things he can have, there have been a few close calls!

Even if you factor the one dose of antihistamine given, the symptoms you listed were significant at the end of the challenge, the swollen eyes , hives , scratching and snorting showed a full blown allergic reaction. Which was certianly not linked to any child 'behavour'.
Bear in mind that antihistamine has a build up effect, and one single dose would and didnt btw halt this food challenge , proving a allergy.

What medical advice did they give you on the day? do you have further appointments with allergy doc after this?

I would expect a child to show some from of behavioural swings in a food challenge setting. You wouldnt responed well to being asked to eat increasing amounts of rat poison would you?

This is a very difficult thing to ask a young child to do.
They have normally been told to avoid that food, and now as the secure adult around your childs world, you are not changing the rules and asking him to eat something that will make him feel dreadful.

He may not be able to verbalise how he feels in terms of allergic reaction, but his actions may have been very telling.
How did you prepare him for this stressful day?

when you mention 'fine with traces' what food stuffs do you consider to be safe?

you need two epi pens for school, and two for after school club and two for yourself. even if you cant get this from your gp or immunologist, two need to be with your child, along with other medication at all times.

Eragon, I think you're being a bit aggressive towards me. Of course I took into account the circumstances around his behaviour, but he was being awful! Normally he'd have lost a load of privileges and he didn't this time because I understood the situation wasn't normal. He knew exactly what to expect and was quite excited, it was his 4th challenge in 6 months and he'd passed all the others. In hindsight it was probably because the initial patch test felt different and it escalated from there but hindsight is a wonderful thing and he'd been acting up even before the patch test.

I was just disappointed that he didn't pass and was unsure as to how severe the reaction was, especially given the antihistamine the night before. To my eyes it was loads better than when he reacted as a baby, then he had hives all over his face and torso and the Gp wasn't concerned as his breathing was ok.

when I say he's fine with traces of I mean if a food says it may contain traces of sesame due to the manufacturing process I still let him eat it. The allergy consultant he is under said that's fine

well, I am sorry to hear that you feel that way, bear in mind that I have a son who has had many food challenges with a mixed response.
I am very aware of the distress that food challenges are to a child. I would expect that level of behavour or a decent amount of distress when going through a whole day of eating allergen. or flashpoints at home after the event.

Our children have a huge emotional burden with food allergies, and each reaction they remember colours their emotional well being for a considerable time after the reaction.

In fact having a family see a child go through a reaction, give them an epi, dash to hosptial is a huge emotional roller coaster. its like putting a whole family in a paper bag, shaking it and them tipping them out and watching how they cope.
So its no surprise that food challenges are distressing for small people, and its something that the pead immunologists really need to give more support in this area.

As for your childs reaction, it is good news that on this occasion it took a large amount of allergen to trigger a response.
But that was his reaction on that day and point in time. it still means that life with regard to sesame is still complete avoidance, as you are very well aware.

Factors that change reaction status from mild to anaphylaxis are.

recovering after a viral infection or illness.
amount ingested
poor asthma control
time of year, e.g environmental allergies (overfull 'allergy cup' iyswim)
and for adults,
alchohol
and time of month for woman.

Teen years and hormones are thought to change allergic status as well, but as yet no complete studies have been carried out,(as far as i know) but immunologists do hear of this peak. perhaps its a combination of hormones and risky behaviour.

So really you have epi pens, and as the docs havent told you otherwise you have a child with a potential for anaphylaxis.

what did the docs say about outgrowing? they must think its on the cards otherwise you wouldnt have been given a food challenge.

Personally we avoid may contains, due to reactions from them. It might be worth you asking that question on its own to other parents and allergic adults on this section.