Allergy tests reveal error in elimination diet

We finally met with the dermatologist this month, who performed skin prick tests on my son to determine whether he has allergies to a number of common allergens.  As it turns out, he is allergic to egg whites, dust mites, and peanuts.  The good news is that he is not allergic to soy.

It is common for babies to have an allergy to egg whites, and also common for them to grow out of it by the age of two or three.  According to the doctor, my son's reaction was mild, and the allergy is probably already diminishing, so we'll avoid egg whites until a skin prick test indicates that it's okay to challenge them again.

During our elimination diet we've eaten eggs regularly, and, looking back over our food diaries, my son's skin worsened most of these times.  The presence of eggs in his diet has certainly clouded the results, and emphasizes that we should have done the allergy testing before commencing the diet.  My hope is that eliminating eggs from his diet will cause a further improvement in his skin.

I'm annoyed about the dust mite allergy, but not terribly concerned.  We will have to be more diligent about cleaning the house, and we are reconsidering replacing the carpet with wood floors rather than new carpeting.  Fortunately, we were planning on replacing the carpeting anyway, so it's not a waste of good flooring.

I'm definitely more concerned about the allergy to peanuts.  All the information I can find indicates that people rarely grow out of it and that any peanut allergy has the potential to be anaphylactic (translate: life threatening).  This means we will never be able to be carefree about eating with our son again.  Not only that, but we will probably have to give up eating peanut butter, Reece's peanut butter cups (not widely available in Australia anyway), and Thai food, due to the possibility of exposing him to peanut.  I'm very frustrated at the moment, because I was given very little information from the dermatologist and will have to wait two more months before I can get more information from an allergist.  A curious silver lining to this is that the incidence of peanut allergy is  becoming much more common than even just a few years ago, so increased demand for peanut free food may make it easier to get it.

I thought my son's skin looked pretty good when we visited the dermatologist, but when the dermatologist chastised me for not using the cortisone I realized that the eczema irritation really was pretty extensive.  He explained that if there was any irritation then the eczema could flare with no apparent reason and create confusing results during the food challenges, which of course perfectly describes what happened during the food challenges we've already completed.  Therefore we are taking a different approach now, using the cortisone to eliminate all signs of the eczema (if it's even possible), use the elimination diet to keep it clear for a few days, then do the challenge.

We also met with the dietitian this week, who tried to decipher our food logs and concluded that my son is probably not sensitive to amines or soy (she had never heard of someone having problems with soy without testing positive to a soy allergy), so we have reintroduced those into our diet.  He probably is sensitive to salicylates, and so we will slowly introduce salicylates into his diet after he finishes challenges for glutamate and bread preservative.  Now that we know about the egg allergy, I'm tempted to redo the salicylate challenge, but that will depend on whether we can get his skin clear enough to make the signal stand out from the static more clearly than last time.

We've now been on this diet for more than two months and I'm getting tired of it.  I thought we would be done with it one day, that we would be free to eat just about anything we wanted, but now I'm realizing that it was probably good practice for what lies ahead with the peanut allergy.  Food that may contain peanuts is even more common than food that contains soy.  Already I've found three things in our cupboard that may contain traces of peanuts, including the cereal my son has for breakfast every day, and it looks like we will be doing a lot of home cooking in the future.

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I found some more balanced information about peanut allergy (well, technically, my dad found it while I was lamenting about how alarmist all the information I found was).  It says that only 1/3 of the children who test positive to peanut allergy with a skin prick test will have any symptoms, and that the vast majority of people who do have symptoms will get hives, experience abdominal pain, or start vomiting.  The page states that allergies to peanuts that are severe enough to cause anaphalactic shock are extremely rare.  Reading this made me feel much better, and when I consider how often I scraped peanut butter out of the jar with my finger in the first year of my son's life, I now recognize that if my son hasn't had a severe reaction by now, then he's not going to have one.