Exposure tests - what to expect

[toileofduty]

Thinking ahead here. DS (6yrs) was diagnosed with a nut allergy at 18 months old - a skin-prick tests showed reactions to all tree nuts, pine nuts, peanuts but the biggest reactions were from Pistachio and Cashew. He is fine with sesame.

The reaction that led him to this skin-prick test was just hives appearing after eating something containing cashew. So 4+ years later he's been going back annually and we've been asked if he's had any reactions and we've said "No" and then have been sent on our way.

Our local health authority doesn't give out Epi-Pens to nut allergy sufferers unless they have asthma.

At our last check up last year, we were told to not come back for another 2 years where they would then probably conduct an exposure test. I am assuming that this will mean that he will be given some nuts to actually eat and they will stand by with the epi-pens in case he reacts. Is this the case?

Has anyone else had experiences with exposure tests? DO you think they will start off with a bit of cashew or pistachio first or will they go for peanut? Is there a risk in doing it?

Be great to hear from anyone who has been through this. I am fretting!!

Do you mind if I piggy back on your thread, since it hasnt been answered for a week anyway?

I was advised to come over here from another thread.
My son is going to have an exposure thread in August.
I too would like to know what will happen.
He has already been somewhere, not sure where, and had an arm test, where he reacted to some stuff worse than others.
He is moderately nut allergic.
He was diagnosed at 8 years old. He is now 24.
He has not had reactions,in rl, not even his usual hives, for several years now.
Thanks

Oh. He has pills and epipens. Always has had, since the diagnosis. And he is asthmatic, if that makes any difference.

my son is NOT asthmatic, and has had reactions, 3 of which require an epi pen.
asthma isnt the requirement for an epi pen. being allergic to a food which can tip you in to anaphylaxis fulfills the need for epi pens.

food challenges are given if previous skin prick tests indicate a drop in reaction, and may indicate outgrowing.
Food challenges are best held in hospital settings, due to the possiblity of anaphylaxis.

yr questions to docs should be why do they think your son has outgrown? (lack of reactions only point to your very good avoidance management as a parent)
and How does the doc approach/plan this testing?

and At what point would you need to use an epi pen if antihistamine doenst work?

good luck!

toileofduty I have no personal experience of exposure tests or food challenge but there is a fab support group on facebook

uk parents of kids with nut allergy peanuts

where a few folks have been thru food challenges

Thank you both of you.

I should have said, that yes, it is going to be done in hospital, with a doctor at the ready. I am not looking forward to it.

I suppose, if he may have outgrown it, that it could still come back at some point?
Would they then leace him without epipends and the pills presumably?
[not on facebook, but might put myself on it]

I will get my son to ask the doctor those questions, eragon.

I'm intrigued at everyone who says their children have had skin prick tests. My GP surgery, plus a dermatologist (my daughter suffers from severe eczema) have absolutely refused to carry this out, saying they ate inconclusive. Instead, we had to try elimination diets- avoiding particular food groups for two weeks ie dairy, gluten and citrus.

The only thing that made a difference was the citrus, to be honest, so we now avoid citrus fruits.

Should I push for the tests? My daughter comes up in hives with what seem like random foods from time to time, but it's not consistent.