Most accurate Allergy test for toddler

[strmis]

Dd is16 mos old. I want to do another test (she had skin test at 6 months and I wasn't very convinced of the results... E.g. It said Not allergic to bananas, but when she ate iit she got itchy and hived up).

What would be the best way to go? Anyone familiar with the food safe allergy test? If so, is Iga, Inge, or a combo the best way to go? What's the difference between the ELISA and food safe allergy test?

[scsigrl]

SPT (skin prick test) and blood testing has about the same reliability which is 50% accuracy for a + result. They only 100% sure test is a food trial.  If your allergist doesn't consider a reaction of hives and itching a + reaction, I would find a new allergist ASAP.  

IgE allergy testing is for allergies that can produce anaphylactic reactions.  Any other food testing is scientifically unsound  in the research I have done and I would not suggest it to anyone.  Also, the "cast a wide net" theory of allergy testing is a bad idea.  Testing for something you have seen reactions to is a great idea for following trends in numbers coming down to do a food challenge but testing just to test is not recommend.  As I said, with 50/50 results it can end up with false +'s and end up needlessly restricting a kids diet.

Good luck figuring things out. It's tough, I know :(

[strmis]

Originally Posted by scsigrl 

 Testing for something you have seen reactions to is a great idea for following trends in numbers coming down to do a food challenge but testing just to test is not recommend.

I didnt quite understand this sentence. Can you please explain? I guess I'm worried about testing foods because she reacted, what I thought, was so strongly to goats milk. I have only (that I know of) been exposed to goat milk a few times since I've even been pregnant with DD2 and I'm worried tht she will react even more strongly to other substances. What I dont want is an ER trip or worse from trial and error. Could that happen at such a young age?

[scsigrl]

If a kid has an allergy they will watch blood test numbers and SPT results to see if they are trending down. If they do to a certain level they will often do in office food trials. These are done under the Dr's care in case of a reaction. 

I know it's scary. My first has life threatening food allergies and it's hard to give him and my other two new foods for fear of a reaction.  My DS has epi pens (which I believe from your description of the banana issue you SHOULD have).  So I know I have my best line of defense for a reaction.  I also only give my oldest foods first think in the AM on a day we will be home to watch him closely just in case.  I do the same with my other two as well because I am unsure if they have any of the same issues. 

Also, if DD had a significant reaction to goats milk, there is a very high probability there is an issue with other animal milks as well.

As I suggested, it looks to me like a visit to a different allergist would be wise. I know that isn't always possible. 

[strmis]

Originally Posted by scsigrl 

SPT (skin prick test) and blood testing has about the same reliability which is 50% accuracy for a + result. They only 100% sure test is a food trial. 

do you have literature on this? The last time we went to the allergist they kinda pushed SPT and said its fairly accurate, at least for negatives. I just want to be able to have an educated conversation when the issue comes up.  I don't want to pay for a test that is worthless, but we did have it done already so would doing it two times make it "more" accurate since there may be some consistency in her reactions (KWIM) ?

[scsigrl]

https://www.nationaljewish.org/about/mediacenter/pressreleases/2011/food-challenge/

http://www.ccjm.org/content/78/9/585.full#sec-5

http://allergynotes.blogspot.com/2011/09/food-specific-ige-tests-arent.html

http://www.medicalnewstoday.com/articles/185263.php

From the NIH (article isn't coming up)

Guideline 3: The EP (Expert Panel) recommends that parent and patient reports of FA must be confirmed, because multiple studies demonstrate that 50% to 90% of presumed FAs are not allergies.

4.2.2.1. Skin prick test 

Guideline 4: The EP recommends performing an SPT (also known as a skin puncture test) to assist in the identification of foods that may be provoking IgE-mediated food-induced allergic reactions, but the SPT alone cannot be considered diagnostic of FA.

Rationale: SPTs are safe and useful for identifying foods potentially provoking IgE-mediated food-induced allergic reactions, but they have a low positive predictive value for the clinical diagnosis of FA.

[Admin note: Edited for copyright violation.  Copyrighted material cannot be posted without the express permission of the author.  Quotations may not exceed 100 words.]

 

 

HTH

[JRoberge]

A food challenge is important - you don't want to with hold food from a child if it's not an offender. And allergy testing is often inaccurate - false positives AND negatives (as in my son's case). With a food challege you can also see sensitivies or intolerances, not just allergies.
 

[Infinity]

DD has severe food allergies. We found a Pediatric MD who specilizes in allergy testing. She recommended doing a blood test at 3 years old. Before that, the child's system is still developing and you may get innacurate information. DD was allergic to dairy, tree nuts and peanuts. She's since outgrown her peanut allergy. When her #s were low enough for peanuts, we did a food challenge in the doctor's office. She still has to avoid dairy and tree nuts - those allergies are severe. She gets a blood test once/year to monitor her #s.

[WhatAllergy]

specific IgE testing has come on a long way in terms of accuracy ... you will now get better than 90% accuracy (both for positives and negatives) with the new technology systems out there e.g. Imutest from www.imutest.com ... but it is only worth testing for specific IgE levels for a particular allergen if there is clinical history pointing to that allergen as a possible cause of the allergy, as previous posters have said.
 

[sbgrace]

Originally Posted by WhatAllergy 

specific IgE testing has come on a long way in terms of accuracy ... you will now get better than 90% accuracy (both for positives and negatives) with the new technology systems out there e.g. Imutest from www.imutest.com ... but it is only worth testing for specific IgE levels for a particular allergen if there is clinical history pointing to that allergen as a possible cause of the allergy, as previous posters have said.

 

Where is the information about 90% accuracy? Does this measure something different than immuno-cap RASTS?

OP, from what I know allergy tests for foods are about 50% accurate in positive tests. That means you have a high likelihood of false postives. There is a significant risk, then, of elminating a non-allergic food based on a false positive if a person goes by tests rather than symptoms. They have a much better track record for negatives. Those are usually, but not always, correct. Even so, any allergist would say reactions trump test results.

If you have symptoms do an Ige test to confirm. Immuno-cap will help the allergist track allergen levels over time to some extent (though how useful that is in a particular person is questionable I think; again, reactions trump tests).