Help deciphering lab results- multiple allergies

[joyfulmomof2]

I recently had my DS (4) and DD (23 months) tested for allergies. (Blood draw). DS had already had one test done at his 3 year well child visit and it showed mild allergy to milk and egg whites. This time he was tested for a whole range of foods and environmental stuff. I will just tell you what the lab results say and you can tell me what (if anything) it means anything to you. (Lol!)

For cats and dogs he tested >100.00 (class 6- not sure what this means?). For these he prescribed Epi-pen Jr- he does have severe reactions to being around dogs and cats- we just didn't realize that his allergy was the highest possible- (according to the Dr.) D. Pteronyssinus (I think if my Google search was correct, this is just the scientific name for dust mites) also tests out of range at 0.41 (class 1). For foods, egg whites is 0.44, cow milk 0.53, corn 0.39 all of these are class 1. Soybean came back at 0.82, class 2. (Does this indicate a more severe allergy?)

Here's the reason I'm asking for help w/these results: we had a follow up meeting w/the Dr. (our new pediatrician- according to the bio on his website, he has a "special interest" in allergies- which is part of the reason I felt that meeting w/him would be promising) and basically he glossed over every result except the pet allergies. He didn't bring up the D. Pteronyssinus, or the corn, and really didn't address the other food allergies. I was looking at my copy of the results later on and noticed the soy being higher than the milk or egg whites- which of course I already knew he had an allergy to. (With milk and egg whites, he scratches a lot, and I find scratch marks all over his back and bottom, plus he gets loose stools- once we eliminated those foods, these issues cleared up- usually if he has anything w/hidden dairy or eggs like cake or other pastries, the symptoms return, but I've noticed they've diminished lately). I've never noticed any type of reaction from him eating soy (or corn) but of course those are in pretty much everything unless you make everything from scratch (which I do a lot of, but I'm not all the way there yet :-)) But other than the everyday stuff that soy and corn is hiding in, his diet is not really rich in either of those things. In fact, I make it a point to mostly avoid soy anyway. (Though I have recently been buying him those Z Bars (cereal bars) lately and I know those contain quite a bit of soy- and I noticed behavior issues sometimes when he eats them).

I called the doctor later on to ask for clarification about the things I was unsure about. He told me the D. Pteronyssinus "means nothing" and I said "well what is it?" and he said "it's nothing". (Ugh!) And I asked the things about soy and he basically said "it won't bother him" and I said "well if he eats it, won't it irritate his gut?" and he said "he'll be fine". (Not exactly reassuring). I guess if he's right, then he's right, but somehow I don't think those results "mean nothing". :-/

So, does this mean I need to be more vigilant about eliminating soy (and corn)? And also, with regard to soy allergy, do I need to look out for soy lecithin and soybean oil?

The other thing is, DD only tested positive for cow's milk allergy. (0.42, class 1). That kind of amazed me, because when she was an infant, I had to eliminate milk, soy, eggs, wheat and a couple other things from my diet or else she had constant spit up, blood in her stool and more. The only allergy I suspected w/her was milk, egg whites and possibly wheat (she does eat this occasionally, but I notice loose stools if she eats a decent amount of it). I gave her something w/butter in it recently and she got a rash around her mouth- same as her brother used to get at her age. She eats egg yolks several times per week and does really well with that, and I was uncertain about the egg white, so I haven't introduced it yet- but maybe now I'll try. I guess my question there is, are these tests accurate at her age? (I actually wonder how accurate they are at any age, as I've heard different answers).

TIA for any feedback!

(ETA info about Epi-pen)

[scsigrl]

Class really doesn't mean anything.  Some people have lower numbers but react big, some have huge numbers and don't react at all or minimally.

Those food levels would lead to a food trial with our allergist.  They are all pretty low.  If you know that your child is reacting, keep them off.  As for egg for your DD, it is virtually impossible to totally eliminate the yolk from the white.  If she's eating yolk okay and you are comfortable I would trial whole egg.

Above everything...IF you are uncomfortable with the Dr you saw, seek out another!  If he's brushing you off, you may find a better fit elsewhere.  We went through 4 allergist over as many years and FINALLY have a Dr. who listens (and answers y emails often within 15 minutes ;) )

[changingseasons]

Lower numbers mean that you have a better chance of outgrowing the allergy, but like scsigrl said, it doesn't predict the likelihood or severity of a reaction.

I would eliminate everything and then challenge each one individually. Usually, when you eliminate a food for a week or more and then reintroduce it, your symptoms will be more severe. That said- if they are true allergies, a more severe reaction could be dangerous. Did the allergist give you a epipen prescription?

How old is your DD? Allergy tests were useless until my DD was about 18 months, and got more accurate after she was 2. Many allergists won't even test before 2 because they're so unreliable.

[devon]

the cut-off for a blood RAST test for allergies is, I believe, 0.39.  So anything less than that is considered not an allergy, and then there is the following range chart:

0	< 0.35	ABSENT OR UNDETECTABLE ALLERGEN SPECIFIC IgE
1	0.35 - 0.69	LOW LEVEL OF ALLERGEN SPECIFIC IgE
2	0.70 - 3.49	MODERATE LEVEL OF ALLERGEN SPECIFIC IgE
3	3.50 - 17.49	HIGH LEVEL OF ALLERGEN SPECIFIC IgE
4	17.50 - 49.99	VERY HIGH LEVEL OF ALLERGEN SPECIFIC IgE
5	50.0 - 100.00	VERY HIGH LEVEL OF ALLERGEN SPECIFIC IgE
6	> 100.00	EXTREMELY HIGH LEVEL OF ALLERGEN SPECIFIC IgE

(although our doc said 0.39 for the absent, so it probably depends slightly on the lab used).

Like the previous posters said though, the higher the number doesn't necessarily mean more of a severe reaction.

With those low of numbers, I would probably ignore them and not treat them as ALLERGIES if I had kids that were not showing major issues.  My son has over 18 food allergies, and honestly, the ones that were in the level 1, the doc said that since he was asymptomatic for, we should just focus on the big ones

... BUT...  since your noticing symptoms correlated to the foods, it is entirely possible your kiddos are having sensitivities to the foods, which are different than allergies but can still be not fun for your kiddos.

If you are noticing a difference when you eliminate them, then keep eliminating them.  Since they are sensitivities, I believe that there is more of a chance they may grow out of them. 

With a value of 100 for cats/dogs though, I'm glad that they gave you an epi-pen.  That is extremely high.

Also - if you are not liking the allergist and he is not answering your questions, then switch.  He should be talking to you about sensitivities vs. allergies anyway, IMO, with the symptoms they presented and the results they got.

[scsigrl]

devon,  That chart is great but do remember that different labs and different tests offer different results. I believe there is the RAST and the CAP-RAST which is more sensitive from my understanding.  So this chart may or may not be helpful in the scope of things.

[joyfulmomof2]

The chart seems to match up with the results we got. Based on that I can see why he would not be very concerned about the milk, egg whites or the corn. I'm pretty sure soy was tested a year ago, so I'm just really surprised that it is a new allergy. And also surprised that he didn't really acknowledge it during the visit- obviously (and thankfully!) none of the food allergies can cause anaphylactic reactions, but to me it still seems like there is a good reason to avoid those foods at least temporarily. It makes sense to eliminate then reintroduce to see if I notice any reaction. The last time he had any contact w/egg white, he got a rash, and I can usually trace loose stools and such back to eating a cupcake or something. I'm just thinking if I eliminate those other things, even if he has little or no obvious reaction, it may give his gut a chance to heal some more. I'm curious to dig out his results from a year ago to compare and see if the milk and egg white allergies have improved.

Btw, DD just turned 23 months yesterday. The test was done a couple weeks ago. I would've been very skeptical if the test had shown NO allergies, but since it did show the allergy to milk, I'm not sure what to make of the accuracy. I will more than likely introduce the whole egg as suggested- hopefully she can eat it. We throw out lots of egg whites in our house. :P

[kjbrown92]

Remember there are also food intolerances. My DS gets a rash on his upper lip for soy, and he has never tested positive for soy on an IgE test. He has an intolerance. So if there are reactions to a food and they're not showing up on an IgE test, that's another possibility (and a lot of allergists don't "believe in" intolerances, just in case you bring it up and the dr brushes you off).