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View Full Version : Tree Nut Allergy Question--Update



infocrazy
11-23-2009, 03:42 PM
Only a second, but DS1 tested negative to everything! He did have a huge response to the control but everything else was negative. Plus, they looked exactly like they did last year, but I don't remember seeing the control look like this so maybe he got a bad skin test.

He has had a cough for a few weeks and she heard some wheezing so that was unexpected...she wants us to watch him for asthma, which we have a family history of so...bummer.

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I question whether DS1 really has a tree nut allergy. What should I ask the doctor at our appt tomorrow? Should we bring almonds to do a food challenge? Should we get a blood test? Should I have DS2 tested? If DS2 has never had nuts, would it even be accurate?

Thanks!

The way too long backstory:

Last year, when DS1 ate a granola bar, he complained that his throat/mouth hurt. He didn't get a rash or have any breathing issues and we didn't do anything but watch him for 15 minutes. He had had the brand before, but not the flavor. I looked at the ingredients and saw almonds. I couldn't remember if he had had them before so we did no nuts from that point and I scheduled an allergy appt.

He did test positive just over a year ago to almonds, hazelnuts, and coconut. However, I couldn't tell a difference from any of the spots. They all looked the same to my of course untrained eye. By the time the dr was done handing me the epi-pen, there was nothing on his back (maybe 5 minutes later) and DS1 was never itchy. They didn't do a blood test.

Since then, I have remembered that he has had almonds before (I love those cinnamon ones at fairs etc..) and a BUNCH of those coconut Dole bars, which I had never until that point realized were considered tree nuts. Also, I looked at the contents of the granola bar and realized that ALL the flavors had the same ingredients, just very slightly different order at the end.

Finally, after soccer, DS was given Chex Mix as a snack. I checked the ingredients and it listed almond flour in its contents so I didn't let him have it. When we got home, he mentioned that he ate that at his cousin's party...and sure enough he did, his cousin and he ate almost the entire bowl. I had checked for nuts, but didn't look at the ingredients.

So, long backstory short, I really question whether DS has a tree nut allergy. We haven't given him any. He and his 2 yo brother ask if something has nuts before they eat it. We carry an epi-pen. His 2.5 yo brother has never had nuts of any kind. I know that skin tests are often unreliable to food allergies. We do have a family history of food allergies and asthma.

I wasn't too thrilled with the last ped allergist so I am going to a different one that is WAY closer so I'm sort of starting from scratch.

Brevity is not my strong point. :-)

MichelleRC
11-23-2009, 04:46 PM
I have a severe tree nut allergy but it is pretty much limited to walnuts, pecans, chestnuts and pine nuts. Almonds and coconut don't cause an allergic reaction (although I generally avoid them because I don't like them) and I am not sure about hazelnuts.

LarsMal
11-23-2009, 06:45 PM
I would take full advantage of starting from scratch with a new doctor. Tell him/her all of the info you just told us and let the doc decide if he and/or DS2 needs further testing. *I* would probably have him tested again, and if the scratch test was positive, have blood work done. That way you can get a baseline level and go from there.

DS has very low positive for hazelnuts and cashews, but none of the other nuts. We still stay away from all tree nuts (he can have peanuts) just to be safe.

FWIW, I have a friend who's DD had testing done and the nurse who checked the results marked her down as being allergic to about 10-12 things on her back. My friend was freaking out. I finally convinced her to get a second opinion and it turned out her DD just has extremely sensitive skin and wasn't reacting to the actual allergen.

So, your DS *could* have had false positives. I'm a big supporter of skin AND blood testing.

parelle
11-23-2009, 06:47 PM
My husband has tree nut allergy (and was diagnosed pretty young - I think he was less than 2). While I'm not sure what the procedure is for children, a few years ago he got a blood test which showed specifically which nuts he was allergic to (highest on walnuts & hazelnuts). It also showed he was somewhat allergic to peanuts, but, then again, barely allergic to almonds. Not that we've experimented, however - which can be a bit of pain when going out to eat. However, I'd like to caution you about not reading ingredient labels - his one serious reaction was to walnut flour in what looked to be perfectly ordinary Trader Joe's pasta.

jk3
11-23-2009, 09:03 PM
I would definitely ask for a blood test and test the full nut panel. My DS's allergies (tree nuts, peanuts, legumes, soy, sesame seeds...) have gotten significantly worse over time. Scratch tests are not always reliable as children with allergies can be reactive to begin with.

MamaMolly
11-23-2009, 09:10 PM
I agree with the PPs. Get a CAP-Rast blood test done. It should be a single blood draw and can tell you a lot. And of course, my endless suggestion to anyone who I think might have even a whiff of a food allergy to head on over to www.kidswithfoodallergies.org. Good luck with the testing, I'm hoping it comes back negative for you guys. FAs are a club you don't want ANYONE to have to join!

oh, and no, IIWY I wouldn't do an in office food challenge at a new doctors. IMO you don't have a good idea of what you are working with. Get the results from the blood test, see how they jive with the skin prick test and the reactions you've been seeing and *then* consider a challenge if that is what your doctor suggests. I'd also ask the doctor's opinion on getting DS2 tested. My DD tested + to peanuts even though I don't think she'd ever been exposed other than traces in food or from breastmilk. I never gave her peanutbutter or peanuts, and it was the one allergen that went up during her last round of testing.

ShanaMama
11-23-2009, 09:58 PM
ITA with PP that the skin test can be inconclusive. In DD2's case, her bloodwork showed her to be allergic to some foods which she tolerates fine.
So I think your best bet is to talk to the new doc.
Regarding almonds specifically, I believe I have a sensitivity or mild allergy to raw unpeeled almonds. Maybe it's the peel. When I eat it, my mouth gets itchy & if I don't stop after a while my throat starts to get tight. I've never even needed Benadryl for this, just stop eating when it gets uncomfortable. I have no food allergies & I've never discussed this with an allergist. Just wondering if your son has something similar- not a true allergy, but an inability to tolerate certain forms of almonds.

infocrazy
11-24-2009, 02:10 PM
bump for update. Great new doc, negative test.

LarsMal
11-24-2009, 05:25 PM
bump for update. Great new doc, negative test.

Yay!!! That's awesome!

MamaMolly
11-24-2009, 05:50 PM
Only a second, but DS1 tested negative to everything! He did have a huge response to the control but everything else was negative. Plus, they looked exactly like they did last year, but I don't remember seeing the control look like this so maybe he got a bad skin test.



:yay: Woooooooo-Hoooooooo! GREAT news! Congrats!!!!!!!!!!!!

infocrazy
11-24-2009, 05:57 PM
Thanks! :-)

The Dr thinks he never had an allergy to begin with, just a bad skin test, but we both agreed to play it slow with bringing them back. First just as an ingredient, then maybe a nut. DS1 is SOOO excited!

Plus, since he had the chex mix with no issues a few weeks ago, she said he pretty HAD a food challenge (contains almond flour) and passed just fine with no issue. We'll still keep the epi-pen around until its expiration in Feb 2010, because really, why not, but I'm relieved with the results!