uKnow Peanut Test

[Jenmag7]

Is anyone familiar with the new "uKnow Peanut ImmunoCAP Molecular Allergy" test?  I have heard talk about it and people saying how wonderful it is and how they can't wait to get it.  I read about it herehttp://uknowpeanut.isitallergy.com/ and I guess I don't understand the hype.  I already know my DS is allergic to peanuts.  I already know he is capable of having anaphylactic reactions.  Why do I need to know exactly what parts of the peanut he is allergic to?  Am I missing something?

[CMdeux]

Probably not, Jen.

This test seems MOST useful for determining who is at greatest risk of severe anaphylaxis.  Those of us who have already seen those kinds of reactions... well, we already KNOW the answer and so it doesn't matter very much knowing which particular protein is the allergen.

For those who are diagnosed via a skin/blood test after a very mild or localized reaction, though...  this information could really be helpful.  There are some proteins which are much less likely to provoke life-threatening reactions than others in allergic patients.  In other words, it probably makes little sense to have a preschool go peanut-free if the risk is relatively low to begin with, and that is a family that (though they'll carry epinephrine) will be able to enjoy a much less restrictive lifestyle than a patient allergic to one of the markers for severe anaphylaxis (I'm recalling there is a breakdown between Ara h2 and Ara h4 sensitization, but please don't rely on my memory!). 

The down side is that this is inherently a game of statistics, so the conclusions will become clearer (and better-validated) as more patients participate in this kind of testing.  At the moment, I'm not sure that it *is* clear how valid the conclusions are, since few patients like your DS or my DD have bothered with testing like this (for obvious reasons-- there's not really a medical need to do it since we already know that they're in that highest risk group).  There are exceptions to those broad categories, too, and there are certainly proteins (and therefore potential allergens) in peanut other than those included.

Does that help??

[Jenmag7]

Thanks, CM, that helps.  I guess someone who's never had a severe reaction could benefit from this information.  It would be interesting to know the results, but I don't really feel the need to fork over the money just to confirm what I already basicly know.

[Scout]

my dd is a class six according to blood and prick,  but has never had more than a hive reaction and that to contact.....anyway

Dr. has said we are either the luckiest or most dilagent patients they have to nevver had gone ana, (not tempting fate).....I think a little of both

my girlfriends son is  a class 4 but has eaten pnut on several occasion (recent diagnosis) and only gets a scratchy mouth....etc....they are getting the test, since it may seem like he is not a candidate for ana.....who knows...

I may get it out of curiosity........

[Mfamom]

so, is this test more accurate than rast or spt?
I'm in a weird place now with my ds.  He has negative rast to pn at this time (has 3 neg), but a 17mm wheal on spt. 
He had mild symptoms to plain m&ms etc when younger, then full blown anaphylaxis age 4.  Since then, nothing. 
No doctor (including Sicherer) will challenge him. 

[Jessica]

I printed out the info for my dd's doctor (regular ped) and we're going to ask about it today. She has only ever reacted to walnut so maybe she would be a good candidate for this test. According to the website it seems like it's more accurate than rast AND spt.

If her regular ped won't do it, I'll have to call the allergist. I'm hoping to save some $$ and have it done here.

[Lisa]

I had this done for my son a couple weeks ago and got the results last Friday.  My son had his first and only anaphylactic reaction when he was 2.  He is now 5.  I wanted it done because he has not had any more reactions...beyond possible contact.  So the results are what I would have expected.....he will react severely to any future contact or ingestion.  Other things I have learned....Ara 1 and 2 when paired together can indicate even more severe reactions.  Ara 3 may indicate the possibility of future allergy to soy and other legumes.  Ara 6, although a minor allergen, is associated with the most severe allergic reactions.  So what do I get out of it?  Really good paperwork substantiating the need for any school accomodations I may ask for; and also no more doubt that it was a fluke.

[CMdeux]

Lisa, that is a lot of terrific information-- thank you SO much for sharing!

[MommyOfTwo+1]

Our new allergist offered us a test like this but we were told we would have to pay out of pocket because insurance was not covering it yet.  The cost I think was around $150.  At the time we declined because he had a challenge just over a year ago and based on the challenge he considered him ana to pn. 

Though you bring up an excellent point Lisa that I haven't even thought about as far as schools go.  I may reconsider the test if we run into issues with his school.

[rebekahc]

Great info Lisa!  Thank you so much!!

[Mfamom]

thank you for sharing that.  Is this test generally available at most allergist office at this point? 

[Mookie86]

Does anyone know if this test also can be used for drug allergies?  I'm allergic to both sulfa and penicillin, and it's severely limiting.  If I wouldn't become ana if I took those meds, it might be worth a few hives and itchiness to widen my antibiotic range, especially since I can take only about 5 antibiotics.  All antibiotics I can take cause GI symptoms and are really unpleasant.

[CMdeux]

No, mookie, this is only for peanut allergens-- it's a break out of individual protein subtypes so that a picture emerges of which proteins are the ones that an immune response is targeted toward.  That in turn tells physicians (though, as noted, the certainty is still investigational at this point) how likely a person is to experience severe anaphylaxis to peanut. 

With an antibiotic, it's all ONE antigen, not a mixture, and people who are allergic tend to mount a wide variety of responses, (as you know).

Have you tried looking at AAAAI's "Ask the Expert" questions?  The reason that I ask is that our allergist is one of their experts on antibiotic allergy and rapid desensitization; he had something fairly recent indicating that penicillin-class allergy may not be as persistant as has always been thought. HTH. 

[Mookie86]

I developed a penicillin allergy within the past couple of years:  head-to-toe itchy hives that lasted five days even with 50 mg Benadryl every four hours. 

I'm wondering if I may have outgrown the sulfa allergy, though.  That one developed 20 years ago.  I got hives, and it resolved easily when I discontinued the antibiotic.  I don't think I even needed Benadryl.

For both, if it's only itchy hives and not potential ana, that may not be a reason to rule it out when looking at antibiotic options.  I'd rather itchy hives and needing a lot of Benadryl vs. intense GI symptoms that are normal side effects for certain antibiotics.

Thanks for that info., CM.  I'll check out that website.

[rebekahc]

Mookie, our allergist also recommended rapid desensitization for DS's drug allergies.  She said we could choose to do it the next time he needed one of the meds rather than give an antibiotic unnecessarily.  Hopefully that's an option for you as well.