SPT predictive values?

[starlight]

Long story short, I'm 33. Last reaction to peanut was when I was 5. Last skin test to peanut was 10-15 years ago and was quarter/half dollar size and bloodwork was .53.

I got my blood drawn for s*its and giggles to do the peanut protein component test. Came back .28. So since it was that low, all components 1-9 were negative.

Had skin test today. Histamine was 10/30. Peanut was 10/30.

Thanks for the vagueness, body. I was given three options: oral challenge, skin retest in 6 months-year to see if it's gone up or down, or just pretend this never happened. I know negative predictive value is high, and positive predictive value is pretty low for both tests. My allergist has a gut feeling I'd pass an oral challenge. i'm not as sure. But I'm not doing anything without more thought and research. I googled and so far all I've found is positive predictive value in children who haven't had a reaction yet/been exposed.

So I'm feeling a little lost here. Does anyone have links to other specific research of wheal size as positive predictive value? Does it being the same size as the histamine a good thing? Like do histamine control wheals tend to be smaller than ones of known allergy?

Do the nasal membranes of people who have outgrown or who aren't allergic still burn when walking by a peanut-dusty area? That happens to me with run-of-the-mill dust too, never was sure if it's just irritation in general or allergy-related.

I feel like my thoughts are just spinning in circles. 

[PurpleCat]

I have no idea!  DD's peanut numbers are greater than 100 as in too high for them to count so your number sounds fantastic to me!

[GoingNuts]

Given that the components were negative, I'd do the challenge!  As long as it's under very controlled conditions, you really don't have much to lose.  Even if you find that you can't tolerate straight up peanuts, not having to worry about "may contains" could be a game-changer. 

[ctmartin]

I agree with goingnuts ... your peanut numbers, uknow numbers, and SPT all look *very* promising for passing a challenge ... if it were me, i would do it.  from what i understand about SPT, the histamine wheal is the benchmark ... all negatives are either the same size or smaller.  at least that has been our experience with SPT ... not sure what the official word is on that

[Macabre]

I'd do the challenge.

Several folks here have posted about how skin reactivity often remains for a while.

This could be amazing!!

[CMdeux]

Given that the components were negative, I'd do the challenge!  As long as it's under very controlled conditions, you really don't have much to lose.  Even if you find that you can't tolerate straight up peanuts, not having to worry about "may contains" could be a game-changer.

SO exciting!!  that it means what it could, Starlight!

[starlight]

Thanks all. Right now I'm leaning heavily toward the 6 month plan. That way if the wheal was small just due to non-exposure or a fluke, in theory it should get at least a little bigger from this week's skin test exposure. And it's winter right now and I so don't want to be messing around with my health during below zero weather.

I did ask my allergist one thing that flummoxed her a bit because she had never thought of it - say I pass oral challenge and I can eat peanuts. But if my skin is still reactive, what happens if I have a cut in my mouth, like if I've bitten my tongue/mouth recently (this happens to me way more often than it should) or had flossing go bad or what not? She said I'd probably have some mouth swelling. But are we talking 'oh there's a bump on my tongue' or 'oh, I look like a blowfish'?

[PurpleCat]

I don't know starlight, but your question once again reminded me how we who deal with allergies, our own or our kids, see the world in such a different way!