Wednesday, March 12, 2014

3rd annual peanut allergy update

Lorelai had her annual allergist appointment at the end of January and exactly like last year, there's good news and not so good news.

First, the good news. We did a full nut panel (skin and blood tests) for the first time, which I requested because I really wanted to know whether she was also allergic to any tree nuts. The skin tests for pecan and brazil nut came up slightly positive, but the blood tests on all nuts came back negative. Woohoo, no tree nut allergies!

{A Lazy Crazy Life}
Marks for all the other 5 nuts were not measurable.

And she was also really good for the entire appointment, even though we had to wait FOREVER and they took a bunch of blood from her. She didn't shed a single tear! She still won't let any doctor near her ears with the otoscope, but she's come SUCH a long way since her early days of sheer terror at any kind of doctor visit.

{A Lazy Crazy Life}

HOWEVER. She still can't actually have any tree nuts on the advice of her allergist, since there's a high probabability of cross-contamination with peanuts, and the high co-existence of peanut and tree nut allergies. The doctor doesn't want her to develop any new nut allergies. So we continue to avoid any and all nuts (except coconut, which she's negative for, and it's a fruit) until/unless she grows out of her peanut allergy.

More bad news: the dip we saw last year in her peanut allergy levels that gave me such hope that she'd outgrow it were apparently a fluke. She's back up to her initial level when we first had her tested. According to her doctor, "The dip in the level in 2013 is not uncommon in food allergic children as there is some variation in the annual levels seen. The reasoning for this fluctuation is not well documented in the literature. This peanut IgE level of 5.06 along with the skin test greater than 5x5 mm screens out offering Lorelai a challenge to peanut this year."

Component Value
• IgE Allergen Peanut 5.06
• IgE Allergen Almond Nut <0.35
• IgE Allergen Brazil Nut <0.35
• IgE Allergen Cashew Nut <0.35
• IgE Allergen Hazel Nut <0.35
• IgE Allergen Pecan <0.35
• IgE Allergen Pistachio <0.35
• IgE Allergen Walnut <0.35
• IgE Allergen Coconut (Fruit) <0.35

REFERENCE VALUES for serum IgE levels
Class IgE kU/L Interpretation
0 <0.35 Negative
1 0.35-0.70 Equivocal
2 0.71-3.50 Positive
3 3.51-17.50 Positive
4 17.60-50.00 Strongly Positive
5 50.10-100.00 Strongly Positive
6 >100.00 Strongly Positive

Big fat bummer. Although it doesn't change anything we're currently doing to manage her allergy (avoidance, epi pen on hand), it just means that she's much less likely to outgrow her allergy before she enters kindergarten, where she'll be in a much less controlled environment than her peanut-free daycare. I know there's so much more awareness these days, but that still doesn't ensure her safety. If someone could tell me without a doubt that she won't have an anaphalactic reaction to peanuts, I'd feel better. But there's no way of knowing, so I picture the worst case scenario and get all mama bear scared for her. :(

At least we haven't had any scares (knocking on all kinds of wood here!!) or problems with avoidance, and the boys are still really good about looking out for her, so she's got lots of people around to protect her. Fingers crossed for a legit downward trend soon though!


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