New test can show just how allergic your kids might be to peanuts
As a toddler, Colton McClure never wanted to eat peanut butter. "He would always push it away," said his mom, Cheri McClure.
Then when he was a preschooler, Colton ate one Reese's peanut butter cup and was fine. After the second one, he threw up. "Something is not right," McClure said.
An allergy skin prick test produced a reaction to peanuts, tree nuts and shellfish.
The McClures, who live in Austin, immediately changed what they did. They wouldn't go to restaurants, for fear of cross-contamination. They looked at shampoos and soaps to make sure nothing Colton was allergic to was in them. They looked at processed foods for all his allergens and avoided them. They even called companies to ask what their protocols were at their manufacturing plants.
"We can go into that rabbit hole of being overly careful," McClure said.
Colton, who is now 7, lived with a restricted menu.
The McClures learned about a new test from the medical testing company Allergenis. The test maps epitopes to figure out just how allergic a person is to peanuts. Epitopes are a portion of a foreign protein or an antigen that stimulates an immune response.
Allergenis sent a mobile phlebotomist to the McClures' house to collect a blood sample. The results indicated that Colton has a Level 2 peanut allergy. Level 1 is the most allergic, and Level 3 is the least.
The information from that test has allowed the McClures to start doing treatments to desensitize Colton to peanuts by gradually reintroducing them into his diet. They don't worry as much about cross-contamination, and he's been able to enjoy food from Chick-fil-A, which is cooked in peanut oil.
"What the test is able to tell people is with this level of allergy, this is how many milligrams of peanut protein they can have," said Dr. Stacy Silvers of Aspire Allergy & Sinus, who treats Colton.
Previous tests, even blood tests, could say whether children have an allergy to a substance, but now how much of a substance they could tolerate or how bad the symptoms would be if they came in contact with that substance.
"There are kids where even trace amounts can make them sick, and there are kids who can also get five to 10 peanuts or less than that and are OK. That's a huge discrepancy," Silvers said.
With this information, doctors such as Silvers have a better guideline on where to start desensitizing patients to the allergen, or it might tell them that desensitization would need to be done extremely carefully or not at all because of their high level of allergy, or it might indicate that going through desensitization isn't worth it because their level of allergy is so low.
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"We may get some information back that 'hey, your kid is still allergic, but it will take a large amount of protein before they have symptoms,❜ ❞ Silvers said.
The test costs $1,400, and whether it is covered varies widely among insurance plans. "Hopefully, that will change with time," Silvers said.
Peanuts are the only allergen for which Allergenis has an epitope mapping test. It is working on eggs and milk. Just like peanuts, there are a wide variety of degrees with those allergies — from kids who can't have any milk or eggs in baked goods to those who can't drink a glass of milk or have a boiled egg but can tolerate baked goods.
These tests are more definitive than a prick test or a different kind of blood test, Silvers said. He had one patient who had conflicting results on her previous tests, but once she did the Allergenis test and the results came back as unlikely allergic, she was able to eat a whole peanut butter and jelly sandwich.
"She doesn't have to avoid peanuts at all anymore," he said.
These epitope mapping tests also will indicate whether a patient has outgrown an allergy, as is often the case with milk and eggs, but not as much with peanuts or tree nuts.
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Allergies are changing in kids. Silvers is seeing more with sesame allergies than before because of a more diverse diet, including more hummus. Introducing peanuts earlier to infants also has been encouraged in the past five years to lessen the number of kids with peanut allergies. Silvers said it will be a few more years before the data are available to see if that push has been successful.
Currently with babies who might have a high risk for a peanut allergy because they have eczema or another risk factor, Silvers will introduce peanut protein with them in the clinic to be able to give quick medical attention, as well as to build up the level of protein they can tolerate.
For the McClures, "it's been much more of easier breathing moments," since the epitope mapping test, Cheri McClure said. They are hoping Colton will get through desensitivity treatments for peanuts "so he has more freedom," she said. They have already done a controlled test with tree nuts, and he no longer has an allergy to those. Soon they'll do a controlled test with crab to see if they can cross that off his allergy list, too.
This article originally appeared on Austin American-Statesman: New allergy test can show just how allergic you are to peanuts
