Peanut Food Challenge

We recently went to the allergist for a peanut challenge. While my 11-year-old has tested positive (RAST test) for peanut protein, he has never actually had peanut. To prepare for the test, I made a peanut butter candy by melting safe chocolate chips, spreading it in a candy mold and putting a layer of peanut butter on top. I then added another layer of peanut butter and refrigerated it until it hardened.

We arrived at the challenge and all his vitals (heart, skin, breathing) were checked. The first level of the challenge was to break open one of the candies so the allergist could put a tiny amount of the peanut butter on a tongue depressor and place some on his tongue. Within minutes, he began complaining that his lip "felt funny". Sure enough, his upper lip was swelling and had developed a hive. We called for the doctor who gave him a healthy dose of Benadryl and watched him to see if further intervention (steroids, epinephrine) was needed. His lip began to return to normal size in a few minutes. We were asked to wait in the office for an additional 30 minutes.

No further medication was required.

While the challenge was labelled "unsuccessful", we learned several things:
  • he is allergic to peanut
  • he did not have any breathing issues related to the ingestion of a small amount of peanut
  • the small amount of peanut he ingested did not require the use of epinephrine
So, avoidance of all things peanut continues. The allergist did share that their office will begin offering peanut immunotherapy in the coming months.I am excited about this area of new treatment and plan to explore it further.

I'll keep you posted.


Jane Anne said...

When I think of a food challenge like that, it makes me nervous. Even imaging being in a safe place with all of the needed medical resources, I still feel nervous. Question- do you feel that because he didn't have breathing problems that isn't an issue? I've always thought one reaction can vary from the next reaction. Thanks for sharing your experience.

Food Allergy Assistant said...

I agree, Jane Anne, food challenges are nerve-wracking. Having been through several (milk, wheat, baked egg, peanut and soy) I do appreciate the information we get each time we do one.

That is true that reactions can vary from one exposure to the next. Because of that, he will still carry an Epi-pen at all times and avoid peanut.

As hard as it was to watch, I think it was helpful for him to identify that his "lip felt funny" and for us and the doctor to have an immediate response. We want him to be aware of how he feels and to get help if something doesn't feel right.

I hate that he has to go through this...

Infant Bibliophile said...

Good for you for staying so positive. I am always depressed for a day or two after we have a failed challenge. My son is only 3 1/2 but we've failed wheat and baked in egg.