Thursday, December 15, 2011

Allergist Visit - Mystery of the Egg

Today Luke had a follow up visit with his wonderful allergist. Seriously, I adore her. The appointment was uneventful. Basically a "how are things going" kind of visit. Which was a bit much considering we now have to drive an hour to their office, but oh well!

We discussed his egg challenge some more. She's still scratching her head over how he was able to eat a scrambled egg, but then a month later had serious reactions to eating baked in egg 3 different times. She explained that 70% of kids with an egg allergy can eat baked in egg, because when egg is baked long enough (at least 15 minutes at 350 degrees or higher), the protein is altered. And for 70% of kids, that alteration is enough to prevent an allergic reaction. The other 30% of kids with an egg allergy can't eat eggs at all without a reaction. Luke fell into that category. But, there's virtually no way that a person can be allergic to baked in egg, and not to scrambled egg. So for him to eat the scrambled egg without a reaction was a bit odd. The only thing I can come up with, though I didn't discuss it with her, is that because he went so long without being exposed to egg, maybe his body was confused and didn't react to the scrambled egg. He did have some redness around his mouth where the egg touched during the challenge, though she wasn't concerned about it at the time.

We also discussed his blood test results. His numbers have always been low when you consider the charts go over 100. His numbers for peanuts were always around 2.76ish, give or take depending on which test you're looking at. His egg numbers were always in the area of 1.xx. Even when he had his anaphylactic reactions to egg and peanut, the blood test following was very low. The blood test that was done in the summer showed NEGATIVE for peanut, and very low for egg. Which would normally tell you that his allergy to both was gone. But, the food challenges showed that they're not.

Normally the doctor would do a repeat blood test a year from his last one (August), and base any future food challenges on the results. She feels that at this point though we can't rely on his blood test results. We'll still do the blood test, to make sure his numbers haven't gone up, but the main focus will be on skin tests since they appear to be more accurate for him. And then of course, depending on the results of a skin test, we would possibly move on to doing another food challenge.

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