Hey,  We are seeing DR Kershembaum.. Also, recommended by John Hopkins and was told is one of the best.

Can I ask what allergist you're seeing? I'm also in Maryland and took my son to Johns Hopkins. He saw Dr. Wood. That was years ago. I'm just wondering if that's who you saw. He is certainly an expert in the field, but I have found Hopkins doctors to be good all around. Never had a bad one for anything.

yeah, this allergist used different prick needles, so they were all in a box and my daughter's skin was wiped clean then a nuse can in and pricked her skin all the way to the end of the needle for an even distribution.  I have an appointment this summer and we'll see how it goes. I have a feeling her milk allergy will be gone by then.

Something I'd like to add.  Don't get too hung up on reputations of an allergist.  In example.  I went to see one of the local allergists here in Utah.  It was at McKay-Dee hospital in Ogden.  He is one of the more reputable  date of the appointment was January 4th 2017.   So recently.  The office still uses single needle SPT!!!  what that means is that first a drop of each possible allergen was placed on my back.  Over 70 total drops. Then a single needle was used to prick the skin under each drop. With a single quick wipe on the same cloth.  Cross contamination was strongly likely, and the speed with which the nurse/assistant went through the test insured an uneven depth of pricking.  Also, while I mentioned at the beginning I have dermatographia so my skin typically reacts to even the saline solution negative control,  he swiped my skin below the collerbone to check, then never looked to see if I got a welt there...

Ending result of the 70ish tests, I welted up to all but 8 spots.  Surprisingly enough this is the first SPT I didn't react at the positive control site. (Out of 7 total SPTs I have had)  I also didn't react to two known allergens.  One is pears.  I get *really* bad oral allergy syndrome to pears.  The sensation I get immediately upon eating pears is a tickling sensation, it's similar to one of those wire scalp massagers that overstimulate the crap out of the scalp.   Not life threatening, just crazy overstimulation tickling sensation. (I get the same from peaches)  I tested if I was still allergic to pears later and found with a taste that yes, yes I still am.  So he took the test results to mean I really am allergic to pretty much all food,  he DIDN'T test me for bee/wasp sting allergy which I specifically requested, and prescribed me rather high levels of antihistamines.  He also scoped my nose to confirm my sinuses really are perpetually swollen shut.  The other treatment options he went with (leukotriene inhibitor of monoleukesat, and steroid nasal spray + Zantac as a H2 antihistamine)  have actually given me relief that I have never had before.

TL;DR  one of the most well respected allergists has a total sh** diagnostic test still in use (he looked to be 70 years old or so.  I doubt he has changed test types. Ever)  however his treatment if my allergies surpassed the other allergist I go to.   I would actually recommend someone go to Tim Sullivan at McKay-Dee's "advanced allergy and asthma"  but to take the test results with a grain of salt.  Also relevant to you is I have peanut allergy now.  I'm 40 years old.  Prior to 2015 I could eat peanuts with no problem.  All of my favorite candy bars for my whole life had peanut in them. Snickers, Butterfinger, Baby Ruth, Pearson nut rolls, peanut m&ms etc.  Now the faintest trace of peanuts leaves me with hives from my armpits to the tops of my feet for 6-10 days.  So that is an example of how a PA can appear at any time.  Prior eating of something means little for allergies.

The hot dog had nothing on it. Yes, he is board certified and apparently the best one in Maryland as said by john hopkins pediatrics -also one of the best in the country. So, I dunno.

I found out from my mom today that my dad was allergic to milk as a baby and eventually grew out of it and her brother also had a milk issue as a baby. So I am hopeful it will go away..

But immune issue exist in my family, Mom has rheumatoid arthritis, my wife had alopecia areata, my sister-in-law is allergic to mangos and walnuts and I have a bit of eczema around my eye brows and sometimes nose.

as a 12 year old I had a stomach issue and they thought it was allergies, had been tested and had alot of positives, which were untrue.. (stomach problem was a clogged intestine)

Manufacturing processes don't remove peanut proteins (if they did, peanut allergy would be a thing of the past - wouldn't that be amazing!), so your doctor's explanation just doesn't make sense.  Also, there's no way your doctor can tell from testing how your DD's breathing is during a reaction.  Are you sure this doctor is a board certified (MD) allergist?

Test results cannot predict the severity of a reaction nor what symptoms might occur; they only predict the likelyhood of a reaction.  The larger the wheal, the better chance of reacting - there's not really a  correlation with severity of symptoms, though.  If you're interested in the research behind this, google positive predictive value skin prick test. 

With regard to her mouth symptoms with the hot dog, my kids used to do that, too - ketchup, ranch dressing, toothpaste, hot dogs, etc. - so it could have been similar to the way tomatoes affect her.  However, I know some hot dogs contain milk, so it's important to always read ingredient labels.   

Yes, you are correct, I should be more specific where he said he thinks it is just one protein based on the fact she didn't react to one's company peanut butter, but did to another companies. Dr said when the peanut butter was processed in their factory it could have eliminated one of the proteins.

No blood test was done to 100% confirm this.

Quote from: allergydemon on March 22, 2017, 12:11:59 PM
I was told she is allergic to only 1 protein in the peanut.

Ok, here's where I see a problem...this cannot be determined without a blood test.  I think you need to seek a second opinion. 

Hey,

Thanks for the replies, We have been loosely keeping a diary of what she reacted too, but there are not many reactions to speak off. As an example she had a piece of HOTDOG from costco, no bun, and she got a small reaction around her lips and that is it.. not sure why. She did wake up 2 days ago with some green goo near her eyes (it was a warm day in Maryland) and when my wife's friend came over her son had the same.. so some type of allergen and that is the day where she got her reaction from the coconut milk ice cream.  I know the coconut is also a very distant cousin to the tree nut family but so far she has had no reaction to Almond milk, Cashew Milk, Flax seed milk, Almond Meal, Corn, any type of bean no fruit reaction or other vegetables. (tomatoes yes, but only where it touches her skin, not on ingestion)

In our family only I have a bit of eczema within my eye brows and slightly around my nose area (dry skin there itchy) my wife's sister is allergic to Mangos and walnuts.. We have given mangos to my daughter and she is fine with them.

No blood tests have been done, just the prick test and one crumbled up peanut and she was pricked with it. No reaction on the first peanut test, reaction on the actual peanut and second prick.

Good news; The first time we took the test, Milk came out stronger as an allergen than the egg, This time around the Egg was stronger and the Milk was just a red spot as oppose to the egg and peanut being more of a raised hive.

When she does have a reaction it does not last long at all, almost as if the body reacts and says.. " crap, I forgot that she can eat that" and all goes back to normal.

I know it sounds silly, but her mood and behavior during a reaction does not change at all.  Her breathing is excellent (As the Dr mentioned during testing)

Plus, we have given her Milk for 10 months prior to knowing she had an allergy and all the symptoms we had at first were, spit up at times, and then the skin flakes around the head and eat.. which we were first diagnosed as " Infantile seborrhea dermatitis "  Anyways, once we knew it was Milk, we switched to Soy Formula and haven't gone back.

Welcome Allergydemon!

You've gotten great advice above, so I won't repeat.

What I would suggest is to start keeping a record of everything she eats, whether she reacts, how long after eating, and what the reaction is.  Also observe what else is going on.  Is she sick?  Exposed to other things that she could be allergic to in the environment?

As PurpleCat mentioned, it may be that her "allergy cup" is full at times, and those are the times she reacts.  For example, if she was exposed to lots of dust mites, pollen, animal dander, etc. that she is allergic to and then eats one of those foods you mentioned, that may be the time she reacts.  OTOH, she may be able to tolerate them at other times because her immune system isn't under stress.

Please understand, I wouldn't  advise that you experiment to see what can make her react.  BTW, did your allergist mention which peanut protein she is allergic to?  Component testing is very new and many of our kids haven't had it yet, so you may be able to teach us something! 

Does your allergist specialize in food allergies?

Was the testing solely skin prick tests or were blood tests done as well?

Blood test results will vary, every time.  I have learned to be less hung up on the numbers and pay more attention to a trend of the numbers going down consistently.  I also pay attention to the total IGE test results (part of the blood test that shows the overall count in the blood regardless of the allergen - it gives you an idea of how much your child's body is dealing with overall and can effect the level of a reaction.)

Reactions and history of reactions will always trump testing. rebekahc explained some of this in her post so I won't repeat.

It is possible that your child has some environmental allergies besides dustmites.  They can make your child more "reactive" to foods at certain times.

For example:  My DD is allergic to Birch trees.  There are fruits, drupes and nuts that are related to the birch tree family.  She is allergic to some of them and she has oral allergy syndrome to others (OAS is not life threatening).  These allergies are worse (meaning she is more reactive during birch tree pollen season). 

Fast forward to today, she has been having allergy shots to some of her pollen allergies including trees, grass and dust.  She recently passed a walnut challenge and is going for a cashew challenge in April and an almond challenge in June.  Being less "allergic" to tree pollen has given her body a break and her body can now tolerate some of the foods it could not before.

By the way, here is a weird thing to file away if you child continues to have a dust mite allergy.  Shellfish are cousins and somehow cockroaches are also related like dust mites.  So when my DD started Kindergarten, there were some days we could not figure out what she was reacting to....until I learned of the dreaded cockroaches and once exterminated...and her classroom cleaned, voila!  Like magic!  (gross, I know....but....little things...)

Now my DD is allergic to shellfish....except she can eat shrimp and does eat shrimp.  Why?  who knows.  The others cause anaphylaxis.

My DD tests not allergic to mollusks, however, she has had anaphylaxis to clams and can not eat them.  She eats scallops all the time!

My DD tests allergic to apples....except she eats them all the time.


There is no black and white answer to our allergy mysteries.  Hang around here and learn from some very experienced people and keep your DD's history, written down somewhere to help guide you.  It's an interesting journey that does get easier as we get educated and as our children grow up and can self advocate as well as actually tell us what is going on and how they are feeling.

Welcome to our group!

Hey, thanks for the reply.

we have seen an allergy specialist. We have done 2 prick tests so far. first results were an allergy to eggs/milk and some dust mite. No peanut allergies even thou we came in because she reacted to peanut butter. The second test showed a reaction to peanuts/eggs but the milk was much lower than the last time. apparently the milk allergy was worse the first time than the egg, seems to have gotten better.

When she was tested the 2 times, the Allergist said there was no swelling or breathing issues associated with her reactions and that its only skin related (eczema) we were given an epipen just in case.

When I meant by swelling was puffiness around the eyes and mouth, but mostly red.. as if she got some a bunch of hives and not one big swell up. Her mood does not change, as if she is not in any discomfort.

like I said, she has gold fish and no reaction, McDonalds fries has milk in it and no reaction.. pizza with cheese on it and no reaction. I have also given her Mac n Cheese to taste and no reaction.

Now the eczema on her skin was mentioned it could be a result of the dust mites as we have carpet everywhere (currently renting)

she will react to tomatoes but only on places where it touches her, so around her lips and such, but I was told that is just he acid and its normal.. she does not react when we give her spaghetti sauce or anything else like that.

How accurate is the 25% chance of her outgrowing  the peanut allergy ? I was told she is allergic to only 1 protein in the peanut. Its why she did not react the first time, or the fact she did not react to the synthetic prick she had.

thanks for reading

Hi and welcome!    I'm sorry your DD is having food reactions - it's so hard when they're little and can't really tell you what they're feeling!

I'll try to address everything you've brought up in your post, but I'm sure others will chime in, too.

1.  Food allergies should not be diagnosed by testing alone because there is a high rate of false positives.  Also, back when my kids were little, our doctors felt like allergy testing was even more unreliable in very young children.  If your DD has eczema, that can also affect the results.

2.  The allergenic proteins in milk and eggs can be affected by heat, so some allergic individuals are able to tolerate baked milk and eggs - the longer the heat exposure the more those proteins are altered.  This is NOT true for peanut protein.

3.  If your DD can tolerate cheese, then I would question whether the milk allergy was a false positive, though.

4.  Most ice creams are cross contaminated with peanuts, so since your DD is peanut allergic you will need to learn about cross contamination and avoid those exposures.

5.  As to why your DD did not react the first time she had peanut - the first exposure to an allergen often will not cause a reaction because the person is not sensitized.  Only after a person has been exposed can she become sensitized and begin to react.  Also, people can develop allergies at any time - even after decades of not being allergic to a food.

6.  If your DD eats something and has skin symptoms in places the food did not touch, then that is a systemic reaction and could be very serious.  If her skin is swelling, so could her throat or lungs and she's not old enough to tell you what's going on inside.  I would strongly urge you to see a pediatric allergist and get an action plan for recognizing and treating reactions (and also to help you figure out what her true allergies are). 

7.  Many children outgrow milk and egg allergies, but I think the number who outgrow peanut allergy is lower.  A pediatric allergist will be able to guide you as to the likelyhood of your DD outgrowing some or all of her allergies based on test numbers, reaction history, etc.

There is a steep learning curve when first having to deal with food allergies, but it gets better! 

So, I was wondering if anyone has been in a similar situation as I have. I am a parent of a 15 month old Daughter, allergic to Milk,Eggs and Peanuts.

First it was Milk when she was a baby, we noticed eczema and her skin flaking.. then we have given her peanut butter and she swelled up and we got her tested. It came out that she has Egg,Milk and Peanut allergies, now here are the kickers.

During the initial test it was only Milk and Eggs, even thou we came in with the peanut allergy. Then with an actual peanut she did react. That was also not the first time she was given peanut butter, she had it before and no reaction whatsoever. She really loves McDonalds fries and there is milk in it. She eats Cheese and no reaction and other foods she is allergic too but baked in.

Can anyone explain why that is ? why she would react sometimes and sometimes she will not. She was given coconut yogurt and no reaction, weeks later she got coconut milk ice cream and she reacted ( like a she had a peanut) Her reactions are only skin based and last tops 1 hour and her swelling goes back down.

If you have a child with similar allergies have they grown out of them ? can anyone explain why she sometimes reacts and sometimes not.



Thanks