A New Wrinkle

I learn something new every time I take Matthew to his yearly appointment with his allergist.  As the vast majority of my blog readers are family and friends who will come in contact with my child at some point, I hope you won’t mind me sharing my newly gleaned knowledge.  This year I learned that the original purpose of IgE (Immunoglobulin E-the antibody responsible for allergies) was to protect against invasive parasites.  In highly developed countries like ours where there is nary a tapeworm in sight, IgE sometimes gets bored waiting around for something to do and starts reacting to innocent substances like food.

The blood tests used to diagnose allergy count the levels of IgE reacting to certain substances.  Matthew has this test done every year and here is where the wrinkle comes in: when total IgE levels in the blood are higher than 1000, you start getting a lot of false positives.  Matthew’s total IgE is 2232.  That means that not only did his blood work come back as positive for the things we know he is allergic to, but he showed a positive for everything else as well (walnut, sunflower, almond, sesame seed, hazelnut).  His skin prick testing only showed him being allergic to milk, egg, peanut, and cashew (the ones we already knew about) so his doctor suspects the others are true false positives but wouldn’t stake his life on it.

Now, what does this mean for us?  Not much right now.  Given the likelihood of his developing other nut allergies, we pretty much keep him away from all nuts.  If we decided we wanted him to be able to eat nuts, we would need to do an oral challenge with his allergist.  An oral challenge basically means we would take him to the doctor’s office and feed him the nut in question and then watch and see what happened.  A few hours would be spent there just in case something went terribly awry and if all went well, we could then start slowly introducing the tested nut into his diet.  Are we going to try this right away?  No.  First of all, I don’t feel a burning need to feed him nuts.  There are definitely more important things in life than being able to give him Honey Nut Cheerios. Second, he is too young to care.  He is already completely nut free and happy about it.  Third, he is three and understandably wary of new foods and if we got him there he probably wouldn’t eat the unknown item anyway.  So for now we’ll stick with our completely nut free lifestyle.  He has had sesame oil and sunbutter (made from sunflower seeds) on occasion and has had no noticeable reactions to either so I’ll continue to use those (with a watchful eye of course) but really nothing else will change.

So there you have it.  Another lesson in Food Allergy 101.  May you never need the knowledge you have gained.