Negative blood test result - what next?

[Smithagain]

Family history: DH is severely allergic to nuts and also allergic to cats & sticking plasters.

DD1 had a peculiar reaction to a bee sting when she was two. Was diagnosed as a likely allergic reaction and Epipen prescribed. She's been on a nut-free diet all her life, as a precaution because of DH's allergy.

Now she's five and has just had blood tests done for allergy to bee and wasp venom, peanuts and a range of tree nuts. All have come back within the normal (i.e. non-allergic) range. So as far as the medical establishment is concerned, she is not allergic to bee stings or nuts. And presumably they will not be renewing her prescription for an Epipen. Which is good news, but a bit scary, because it's been comforting to have it, with our history.

Questions -

1. Is there any risk that the fact she has never (to my knowledge) eaten any nut will have skewed the blood test results? Because her blood has had no opportunity to make antibodies to nut proteins. And if there is such as risk, how safe are we in assuming that she really isn't harbouring an undetected allergy.

1. We are now faced with the prospect of exposing her to nuts for the first time, which makes us all feel rather nervous. Any advice on how to do it in a controlled manner?

Hi Smithagain,

wrt. your first question _ I guess there is always a chance that she will react but I think its pretty unlikely. Ds1 tested positive for peanut allergy at 10mo without ever having a peanut and I've heard similar stories from other mums. However our kids are being exposed it obviously only takes microscopic amounts and happens early in life. So if your daughter is testing negative at age five she most likely isn't allergic.

Having said that I would proceed cautiously, for your own peace of mind apart from anything else. My plan for the day when ds1 avis given tree nuts ~(age 5, he has also tested negative for them) is a picnic in the park directly opposite to the entrance to A&E at the childrens hospital. That may be seen by some as extreme but I don't think I'd dare otherewise. If you feel braver then a bottle of piriton, a second adult and a telephone nearby should do it. After all, most people find out their lo is allergic to nuts without any warning, special arrangements etc

At the end of the day although allergic tendency runs in families specific allergies don't tend to, so she should be fine. And once you know think how wonderful it will be not to have to worry.

First of all allergies can happen at anytime. My DS 12 was eating peanut butter and nuts , seeds until he was nearly 5 before he had a reaction, then he had reactions to seseme seeds and pecans in one weekend and then couldn't eat any nuts including peanutswithout frothing at the mouth or throwing up.

I guess that's part of the reason we are feeling a bit nervous christy. DH had no discernible reaction to nuts until he was seven. Ate the regularly before that. Now he can't even be in the same room

It was psychologically easier treating DD as if she was allergic and had to avoid them. Giving them to her is scary. But I know that we need to, because we can't keep making special arrangements for parties etc if there is no medical need.

I think I need to talk a very good friend into supporting us when we expose her for the first couple of times. Obviously DH can't be involved, because he wouldn't be able to handle the food.

I was a bit like you with trying my dd with eggs and nuts as my ds is allergic to them.

I avoided giving her anything with egg for ages, then we were invited to my sister's for a party for her birthday and my sister just said 'hasn't she had any cake yet?' and just gave her a mouthful. Had my son's piriton and epipen but, needless to say, dd was fine.

Once she was 2yrs, I also tried her with peanuts at home and that was fine too.

All that worry, for nothing...luckily

I like the idea of a picnic in the park near the a and e dept. Go on, do it, with a non-panicky friend on hand.

Let us know how it goes.

I also have a severe peanut allergy (epipen in tow etc).

Is there any reason for her to have nuts? I mean just because she's been tested as not allergic, doesn't mean that you have to give them to her?

Or is the idea to boost her immune system to them?

Love the picnic by A & E idea!

Will use this for DD and DS when the time comes.

ilovemydog - yes, we do feel we need to let her have some. Not because we want her to have them - would be quite happy for her not to eat them ever. But we can't keep asking friends to jump through hoops to avoid feeding her nuts and we would rather expose her to them in a controlled manner. Otherwise the risk is that she first encounters them at some birthday party when we're not present.

Clearly our home will remain nut free and we are going to have to work on a protocol for making sure that she doesn't bring any nut traces home if she's been out at a friend's house.

Turniphead - the Dr did talk in general terms about proceeding cautiously and trying her with small amounts of one type of nut at a time. But she didn't actually give us detailed instructions. Maybe I should ring her and ask.

There is a park reasonably near our local hospital. I think we might be taking a trip there sometime over the summer holiday!

Maybe try with a paste on her arm first as if she is severely allergic that could react a bit - not full proof of course

Please remember it's often the SECOND time that there is a reaction. DS had a few hives after eating chickpeas, the next day he had them again and had full anaphalactic shock.

When we've done allergy 'challenges' in hospital, they have always tried a tiny bit on the forearm, then a bit on the lips, then slowly ingesting some... waiting and observing 20 minutes in between each try.

Do it at lunchtime so if anything goes wrong you've got the rest of the day to recover! I'm sure she'll be fine.

Thanks. Yes GTG - I'm very conscious that it is often the second time. It must have been very scary to have such an extreme escalation.

Am also slightly concerned that it could take us months to do two or more controlled exposures to all the various varieties of nut. Will need to keep records or I'll lose track of what she's had!

Well good luck. I've got to do the same at some point as dh has a nut allergy. What about trying really processed nuts first? Eg pesto? DH has a problem with real coconut but is fine with Bounty bars! He can also eat ferrero rocher as the nut inside has been 'processed' of sorts.

I don't think processed nuts make that much difference. DS worst problems are with hazlenuts which are usually processed in chocolate. They are the worst as they are often ground and used in bars like Milka which look like ordinary milk chocolate.

DH is allergic to Brazil nut and even the chocolate around them makes his mouth go strange.