IgA? IgE? Allergy testing? Help! - Mothering Forums

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#1 of 12 Old 07-14-2008, 08:19 PM - Thread Starter
 
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I've posted here a couple of times and lurked lots and right now I'm feeling really overwhelmed and need a bit of a crash course, if anyone is up for it! My ds reacts to dairy and to eggs, as far as I know. Dairy was pretty obvious, and pretty much all through my breastmilk - he tried it twice directly before we gave it up completely. He had most of the classics: "collicky", gassy, stuffed up, excema, not sleeping (well, he still doesn't really...), he even stopped gaining weight for a bit, etc., as well as a red "welty" rash on his face after each time he had something directly. With eggs, he'd had yolks directly about 3 times ever - no whites - and threw up each time within an hour or so. Otherwise, though, no real issues with small exposures to egg-containing foods (mayo, etc...) or through my milk. Got rid of all exposures for him after the 3rd try with the yolk, though I haven't eliminated it for me and am still bf.

So we got allergy testing done (RAST) and everything came back negative. Surprising to us, but not shocking...he's only two (just under when he was tested) and I know they are not 100% reliable, esp in young kids. Doc doesn't want to do a scratch test - we don't want to put him through it at this point, either. We've been referred to a pediatric allergy clinic and are waiting for an appt.

I don't understand, though, the ins and outs of testing and diagnosis, and of allergy vs. sensitivity. I've also read reference to IgA vs. IgE allergies - I can't find much out there on this, could someone help me out? As far as I understand, is the RAST testing just for IgE reactions? Afaik, there is not testing for sensitivities, right? So if it's "just" a sensitivity, does that mean there's no risk for it becoming anaphylactic? I'm so confused and over my head here - I don't trust the ped or really the other docs, so far I seem to know more than they do, and I'm at the end of what I "know" at the moment .
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#2 of 12 Old 07-14-2008, 08:44 PM
 
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Don't have time to type much... but you're right- RAST will only test for IgE allergies, not IgG or IgA or the others.

There are other alternative tests that will test for others- like ELISA tests for IgG, and ALCAT tests for something else (inflammatory response?).

I think that normally food sensitivities/intolerances aren't anaphylactic, but I wouldn't say never. Their symptoms can get progressively worse with each exposure, and they can eventually lead to 'true' allergies.

Mom to DD1 (10/07) and DD2 (3/11)
geek.gif I blog about our life with food allergies and eosinophilic disorders.
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#3 of 12 Old 07-14-2008, 09:17 PM - Thread Starter
 
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Thanks - that helps. So are the "alternative" tests like ELISA, etc. (which I've heard of here, but again, know nothing about) alternative in that they are other options to the RAST testing in general, or more like alternative like "alternative medicine" (does that make sense?). Would we talk to the ped about getting that kind of testing done, or would we go to a ND or someone else? I'm really wanting to go see an ND in my area anyway, but the cost is prohibitive and I don't think we could afford it for more than 1 or 2 appointments, which I don't think would work!
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#4 of 12 Old 07-14-2008, 11:20 PM
 
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They are more like alternative medicine. Most allergists won't use them. We did get our ped to write an authorization for our ELISA so that insurance would cover it though, so it's worth talking to them about.

Mom to DD1 (10/07) and DD2 (3/11)
geek.gif I blog about our life with food allergies and eosinophilic disorders.
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#5 of 12 Old 07-15-2008, 12:06 AM
 
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My allergist uses ELISAs for blood testing. The ELISA he uses is a combo panel though, testing for both IgE and IgG. He's a very progressive allergist, often referred to by NDs. So it's definitely worth mentioning to your allergist.
The reason many allergists won't put any stock into ELISAs is that often when they are treating an IgE "true" allergy, they purposefully invoke an IgG "intolerance" in hopes that this less severe allergy will sort of "take over" the immune response. That's the best way I can think of to explain it, anyway.

Wife of Michael , SAHM to Aristotle 09/99 Raphael 06/07 and Marius 05/09 Known only in dreams but never forgotten: Euphrates Decluttering 290/2010
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#6 of 12 Old 07-15-2008, 12:07 AM
 
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I don't know why your allergist thinks the skin test would be traumatic. My dd had it at 15 mths and it was no big deal at all, other than she hated staying still for 10 minutes. Also, we got all neg results on the RAST but got positives on the spt, which were verified through elimination (and one of her allergens was corn, which I don't think I would have figured out on my own). If your allergist isn't comfortable doing spt on a child, definitely see the pediatric allergist. Our is pretty good as mainstream docs go, and like I said, the test was helpful to us.

We never did any other testing, like ELISA and ALCAT, though we did figure out a slew of sensitivities through elimination and food journaling (most of which she's outgrown through gut-healing).
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#7 of 12 Old 07-15-2008, 11:47 PM - Thread Starter
 
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Thanks, all! Wow, it didn't really occur to me that we may get positives from a skin test where we got negs on the RAST - I guess the blood test for some reason seemed the more reliable to me... I'll definitely consider it again. One thing I don't really understand is the function of each test - the RAST tests for antibodies in the blood, while the skin test measures histamine response, yes? But they are both checking for an IgE as opposed to any other immune response?

We're not seeing an allergist as of yet (have an appt in Sept.) - we were referred to the ped by our family doc and she deals with just the allergy thing, no other aspect of his care (though she's not an allergy expert, per se...). I will do some more research and ask about the ELISA test when we see the allergist - so it tests more for "sensitivities or intolerances" than allergies? What is the difference, then, between and intolerance and an allergy, if they are both immune responses and can even be tested for as such?

I just have so many questions!

thanks again!
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#8 of 12 Old 07-16-2008, 01:30 AM
 
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Quote:
Originally Posted by RubySlippers View Post
I will do some more research and ask about the ELISA test when we see the allergist - so it tests more for "sensitivities or intolerances" than allergies? What is the difference, then, between and intolerance and an allergy, if they are both immune responses and can even be tested for as such?
Exactly- RAST tests for IgE, or "true" allergies, also called immediate-reaction allergies. ELISA tests for IgG (and sometimes additional antibodies), or delayed-reaction allergies, also called sensitivities or intolerances.

They really are all allergies... all cause an inflammatory response in the body, just different types of responses. IgE allergies (usually) cause an anaphylactic reaction, but IgG (usually) cause other types of inflammation- in the skin, digestive track, etc. Most allergists (and much of the general public) only consider IgE allergies to be "true" allergies. But we know the truth here.

Mom to DD1 (10/07) and DD2 (3/11)
geek.gif I blog about our life with food allergies and eosinophilic disorders.
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#9 of 12 Old 07-16-2008, 11:17 AM
 
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It annoys me so much when I see a "scientific paper" about how there is other testing for food allergies and it isn't accurate, and that so many people think they have food allergies when they don't, and it's all because they only see a positive skin test as an allergy reaction. Yes, my 2 week old DS was projectile vomiting whenever I drank milk because "he thought" he had a reaction to food.... yeah, right. That must be it.

So far, the ALCAT test, and the rotation diet they gave us, was awesome. After scratch testing, with no food results, and intradermal testing, with no food results, finally we got to the bottom of it.

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#10 of 12 Old 07-16-2008, 04:07 PM
 
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Kathy,

How much did you pay? If you don't mind sharing.

Mom to DMI & Silly Apple
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#11 of 12 Old 07-16-2008, 08:47 PM
 
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http://www.alcat.com/catalog/index.p...=index&cPath=1
this has the pricing. my insurance would cover if I could get my ped to write for it, which he wont.
just fyi, I am trying to get this test for my lo but I just tried calling them 2 days ago and still no call back... I have been tryin to set this up for 2 weeks now. I know kathy had a great experience with them, I think I just havent lucked out. they cant arrange our blood draw because lo is too young ( 9mos) and my ped and allergist wont even hear about ordering this for me. if my ped would order it, then the ped phlebotomist in his office could draw the blood and save us a nightmare trip to lab corp, which we would have to pay for. I dont want it to sound like I care about the money, it would be worth every penny...I just want dd to have someone who is used to sticking babies. I wont allow her to be stuck over and over, kwim?
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#12 of 12 Old 07-16-2008, 11:05 PM
 
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I had the "stuck over and over" experience with my DD but she was a trooper through it all. They even gave us quinoa for free on the test, because it had just passed through development (of course, both of my kids reacted to it). I paid out of pocket for my kids, but I did get their regular pediatrician to write a prescription for it, so I submitted it to insurance to see what would happen. Even 50% would be nice. I did 150 foods for DS and 200 foods for DD (because she reacted to so many when I first did the elimination diet with her). The rotation diet isn't that fun (especially with the two kids reacting to different foods) but if it helps them heal and stops them from developing new sensitivities, then it's great. Unfortunately for non-allergy reactions to food, there is no testing that is really approved by all the insurance companies.

Kathy, mother of 3, wife of 1. My new recipe blog: www.kathysrecipebox.wordpress.com (no longer searchable by allergen, but at least it doesn't have a virus!)
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