Monday, July 11, 2011

Allergy Update

We finally received an update from the allergist last week.  Callie had blood drawn for further allergy testing at last month's EoE clinic appointment.  The results were misplaced and then with the holiday weekend we did not receive an update until the middle of last week.  She tested NEGATIVE for everything!  Can you believe it?!  I started getting excited and hopeful that perhaps she is not allergic to everything, but the allergist explained why the tests showed conflicting results.

The blood test tested only for IgE-mediated allergies (immediate sensitivity involving allergic antibodies).  The patch test revealed delayed sensitivities which are not associated with the antibodies -- it is a different immune mechanism at work.  The tests can, but do not always overlap in results.  Apparently some people have significant reactions to one and not the other, yet they are still are meaningful in terms of allergies.  Neither test is 100% accurate, as this type of accuracy does not exist in the allergy world.  The test results are used simply as a guide.  

At this point we will stick with the patch test results and assume Callie is just not a very classically allergic child.  We will gradually introduce the foods that came back without a reaction (green beans, carrots, corn, peas, apples and bananas), and then begin with foods that showed some reaction.  

To recap, this what we show Callie has a [delayed] allergy to: soy, wheat, egg, turkey, beef, chicken, oats, pork, potato, and milk.  Even though the blood test (IgE) showed a negative reaction to the following: apple, banana, beef, chicken, cod, corn, egg white, milk, peanut, pork, rice, soy, wheat, green bean, oat, pea, and barley.

It is confusing to get conflicting results (patch positive, IgE negative), but I guess this can happen when testing a different mechanism of allergic response.  Overall I feel a little encouraged to have some negative results and hope this means Callie's allergies are not extreme.  Only time will tell.  We re-introduced apples to her last week as her first solid food since getting her tube at the end of March.  I am happy to report she is doing okay with them.  She is not exactly an eager eater, but she will open her mouth for the spoon and will eat up to a half of container of stage 2 pureed apples.  She seems to have retained her oral motor skills and can move the apples around and swallow properly.  This is very good news.  I look forward to her feeding therapy sessions now that we can finally use solids again.  Hopefully Callie will continue to accept apples and maybe even start to enjoy them over the next two weeks or so.  Owen loves to demonstrate how he loves applesauce, so hopefully she will soon follow suit.


faithc on July 11, 2011 at 9:43 AM said...

M used to show a very low positive allergy to peanuts on the blood test and a very big positive skin test (prick). Now, his blood test has been negative for 2 years, but his skin test is still positive (though the welt gets smaller each year). However, we were just on a plane, and he had a reaction (red eyes, sneezing) and had to take Benadryl. The whole conflicting allergy testing info is annoying.

Great news on being seizure-free! :)


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