Are the allergy scratch tests really as accurate as they cla

I'm quite sure my son has allergies. :His symptoms were: reflux (he vomits approx 3 times a week), eczema, overall itchy sensation on body, enlarged adenoids, diarrhea. Anyways the doctors I have seen have not been very helpful. The only help I recieved was in regard to my sons adenoids, from 2 different excellent ENTs, dr Dolitsky and dr Goldsmith. The other 3 ENTS I saw before were unhelpful, the allegists I've seen were unhelpful, my pediatrician is clueless about how allergies work, etc. Sorry for blabbering but its very stressful. Anyways one year ago I decided to take my son off of dairy and soy, and his adenoids and eczema and diarrhea and all improved dramatically! B"H! Then 3 months ago just the eczema and itchiness came back.. So I recently went to see an allergist and he did a scratch test and told me everything came up negative so DS doesn't have allergies. He managed to explain all of my son's symptoms away..... ":He had hives last week? Probably viral....The eczema is random....etc." I was like "OOKK..." But I figured what the heck and I tried putting him back on dairy and soy and the diarrhea and reflux came back. I have an appt with a new allergist tommorrow and I'm hoping she will be more helpful. Anyways I'm wondering if any of you has had a scratch test done on either yourself or your child and it came up negative but it was wrong?

gold21, I am so sorry that you and your son are suffering through this.
Unfortunately intollerances do not show up in scratch tests.
My daughter has very high intollerances to milk and soy. She gets very sick from them. They do not show up in the tests. We had to figure it out on our own with the help of our pediatrician.
What is interesting is that when dd had an endoscopy, her gastroenterologist saw some allergic cells. There were only some and were considered in the "normal" range, but her gasto told me that we don't know what the allergins could be doing to her immune system (infections, etc. which she often gets), and that I should not only keep her off dairy and soy, but to go as far as reading every food label and not giving her anything that could even have trace amounts of soy in it, etc.
All I can offer is hugs and empathy. May Hashem send Refuos and Yeshuos to our little precious ones.
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Really Awesome Mom!

HUGS. My dd also has a very bad milk allergy but thats already under control, b'h. Then she suffered a ton from extreme eczema , itching and all that crazy stuff, sleepless nights... bloody, itchy. I went to someone that does allergy testing and she is allergic to food coloring! It was such a yeshua when we got this diagnosis! B'h she was eczema free since then. You can imagine the shabbos parties in school every friday, and every other week, show and tell, siyum, birthday... Now I send along a huge bag with my dd allowed food and she gets that instead of all the other junk. That's how it was for 2 years. BUT, this summer her eczema is back again all over her body! Don't know what to do to ease the itching?!?!

The tests are not 100% accurate. I remember looking into it and there is a higher false negative rate than false positive rate. I'm sure you can find more info if you google it.

They're difinitely not 100% accurate. When my son was 4 months old we went for the test because he had eczema and asthma. I was off milk on my own already, because I felt he was worse when I had milk. He tested positive for eggs and peanuts, but negative for milk. I came home and had a huge milk party, and the next day he got a massive asthma attack. As they say, "the proof is in th pudding" - I went off milk again. The end of the story is that a couple of months ago I went again, and this time he tested positive for milk. What kind of doctor did you go to? If it didn't show up with conventional testing, you might want to try one of these "voodoo" people, though I sometimes feel they overdo it. Or you can try an elimination diet. Try taking him (or yourself, if you're nursing) off wheat, eggs and milk (the main culprits). If there's an improvement, try re-introducing one thing at a time, and see if it makes a difference. Good luck!
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A balanced diet is a (chocolate chip) cookie in each hand.

Executive Member Joined: May 20 2007 Posts: 418

Have you considered seeing a Gasteroenterologist? It looks like a portion of your child's symptoms are GI related, and that those are the biggies for now.

Is your child gaining well? There could be an absorption component here.

Gold Member Joined: Nov 01 2009 Posts: 1531

My niece is allergic to wheat, dairy, eggs, fish, soy, nuts and shellfish (LOL).

Only eggs and shellfish showed up on the test.

The best thing to do is take out all the possible problem foods and then after a week or so add them in. Soy is a big allergen.
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Never mistake activity for achievement.

Senior Member Joined: May 10 2010 Posts: 120

I was tested as a child and went off the foods that I was allergic to according to the scratch tests. However, I was still suffering terribly from all my allergic symptoms. I went to an ENT (Dr. Goldstein in Queens-if anyone needs him, he is unbelievable,) who told me to go off milk, chocolate, and tomatoes. Within two weeks, all my symptoms disappeared. I was a totally different person! So no, I don't believe that scratch tests are accurate.

Executive Member Joined: May 20 2007 Posts: 418

Diamond Member Joined: Jan 19 2006 Posts: 2836

Skin testing is accurate for real allergies. In tolerances and OAS will not show up on a skin test. My son tested negative by blood and skin for corn, but had horrible reactions when he ate it. we took him off it for over a year, and when we retried it, we found he had outgrown the intolerance.

The good news is in tolerances are usually outgrown, so if you keep him off it for another few years, he may very well be fine with it some day soon.

BTW in tolerances can be nearly as bad as a true allergy.

Gold Member Joined: Nov 01 2009 Posts: 1531

Thanks everyone for the responses! The allergist I went to told me as a definite fact: "scratch tests are extremely accurate. sometimes youll get a false positive but youll virtually never got a false negative, so if you get a negative that means you dont have an allergy" I didnt think he was right but I nodded and said "thanks so much, take care" and in my head I was thinking about which allergist I will see next... Anyways I missed today's appt with that other allergist unfortunately, but I rescheduled and hope to go soon... I appreciate everyone's input.

Executive Member Joined: Dec 22 2008 Posts: 375

I had a horrible experience with a scratch test when it was done for my two year old. He was screaming in pain each time he got pinched with the needle, and I'm sure I was crying myself! First they tested him for wheat allergy and it came up positive, so then they pricked him w/ all of the 5 or so different kinds of wheats (oat, barley etc), and lo and behold, none came out positive. So there - now how accurate is that?
To make a long story short the doctor said he is allergic to everything, from potatoes (!) eggs, milk, nuts, you name it. I think I can be just as good a doc as he.
And on top of that there was a great ending to that visit. That evening after the testing, my son had major trouble breathing and was pale as a ghost. We called Hatzolah and they said he is having a major asthma attack, (first time I heard of asthma as he was my oldest and no one in my family suffered from it). Turns out the scratch test must have injected a huge amount of s/th or other that he was very allergic to. To this day I still don't know what my son is allergic to, he just has minor eczema by now and mostly ougrew it. And in my heart I still want to sue that doctor someday....

Hi, I will let you know that my 1 1/2 year old son had a scratch test and 2 blood tests and all came back negative !! However, he is for sure allergic to milk because whenever he has dairy he will get eczema. Also, just last week my husband went to an allergist to test if he is allergic to anything because of some symptoms he has and he had the scratch test done and it came out negative. The allergist told him to come back 2 days later- he had another type of test with shots done and it showed that he WAS allergic to dust. Also, there is an AMAZING cream that works wonders on my sons eczema (and terrible diaper rashes too). It is natural without all that hydrocortizone. It is called clear cream. (from Israel, I get it at my local Jewish pharmacy) Good luck!

Diamond Member Joined: Jan 19 2006 Posts: 2836

Diamond Member Joined: Jan 19 2006 Posts: 2836

mommy3.5, yes its who you think! my appt was 10:15. my morning ran really late and I missed it! thats so funny that u had an appt 2day too!

Executive Member Joined: May 20 2007 Posts: 418

My doctor told me about
this wall street journal article and it helped me understand. And it helped me understand that there's a lot we don't understand.

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Grayson Grebe started getting eczema on his cheeks when he was just 4-weeks-old. At 6 months, he was diagnosed with allergies to wheat, dairy, eggs, nuts, oats, rice, barley, chicken, pork, corn and beans; his mother, who was breast-feeding him, had to stop eating them all. At 10 months, doctors cut out 20 more foods, including all fruits and vegetables, and put Grayson on a hypoallergenic formula. Even so, his eczema was so bad that his parents put him in mittens, long-sleeved shirts and long pants so no skin was exposed. "Otherwise, he'd scratch himself until he would bleed," says his mother, Amy Grebe of Albuquerque, N.M.
Is It Really a Food Allergy?

The first step in diagnosing two-year-old Grayson Grebe's allergies was to treat his severe eczema.

At wit's end, the Grebes took Grayson to National Jewish Health, a hospital in Denver that specializes in allergies and respiratory diseases. Doctors there suspected that his food allergies might not be causing the eczema�and that some might not be food allergies at all. After carefully supervised "food challenges"�giving him tiny amounts and monitoring him closely for signs of a reaction�a number of foods went back in his diet. "We came home with 12 foods he could eat," says Amy Grebe. "It's made so much difference in our lives."

For parents of children with food allergies, this may be both welcome and unsettling news: Many kids whose allergies were diagnosed on the basis of blood or skin tests alone may not be truly allergic to those foods, experts say.

Blood tests measure the level of antibodies, called immunogloblin E (IgE), a body makes to a particular food. But having IgE antibodies doesn't mean that a person will actually have an allergic symptom when they encounter it.

Skin-prick tests are slightly more predictive, but there, too, a red wheal in response to a skin prick doesn't necessarily mean that a child will have an actual allergic reaction to that food.

The only way to know for sure�short of encountering the food in real life�is with a food challenge test in a doctor's office or hospital. But those can be time consuming, expensive and nerve wracking, especially for parents who have seen a child encounter an anaphylactic shock, a life-threatening reaction in which multiple organs quickly shut down.

With use of allergy tests booming, more parents are coming away not fully understanding what they mean. That sometimes frustrates allergy experts. "When I first started doing this, my biggest job was convincing families to avoid a food. Now, the biggest job is to get families back on a food," says Hugh Sampson, a professor of pediatrics in the division of allergy and immunology at Mount Sinai School of Medicine in New York.

Several recent studies have underscored the gap between IgE antibodies and actual allergies. In this month's Journal of Allergy and Clinical Immunology, researchers in Manchester, England, reported that when 79 children who tested positive for peanut IgE antibodies were given food challenges, 66 of them could eat peanuts safely. At the American Association of Allergy, Asthma and Immunology (AAAI) conference last year, doctors from National Jewish reported that of 125 young patients given food challenges, more than half could tolerate foods they'd been told to avoid.
[HEALTHCOL]

Confusion over test results has also made it harder to track the true prevalence and growth of the allergies. It's widely estimated that some 12 million Americans, including four million children, have food or digestive allergies, up 18% from 1997. But that includes food intolerances, which don't involve the immune system.

A national sampling from 2005-2006, which also included blood tests, found that 9% of U.S. children had a sensitivity to peanuts, 7% to egg; 12% to milk and 5% to shrimp. But experts believe that only about one-tenth of those children will actually have allergic reactions to those foods. Even the true rate of fatal reactions to food allergies is hard to gauge: Estimates range from as low as five to as high as 200 per year.

Experts agree that the most important part of a food-allergy diagnosis is a history: What did the child eat and what kind of reaction did he have? Even if it seems clear-cut, most doctors will also do a blood test or skin-prick test to confirm that the child has antibodies to the suspect food.

"If you come to me and say, 'My child ate a peanut butter sandwich and within 15 minutes, his lips turned blue, he got hives and threw up,' that's enough to tell me the child has a peanut allergy," says Dr. Sampson. "The more typical history is that they were eating a meal and he had this horrible reaction and they think it's peanuts. It's important to do a skin or blood test to make sure."

Some experts believe it's not helpful to test for food allergies when there's no history of problems with those foods. But what often happens is that a child has a bad reaction to one food and the family is anxious to know if they should avoid others, too. Or a parent or a sibling has a food allergy, and a family wants to know if others are at risk. Some doctors will then screen the child with extensive panels of allergy blood tests that may come back showing the child has IgE antibodies to a wide range of foods.

"I see it all the time. A family goes in for one thing and comes back with a laundry list of foods they are supposedly allergic to," says Jodi Stokes, whose son Kevin has food allergies, and runs a support group for allergic families in Charlotte, N.C. "I tell them to go to a board-certified allergist who knows how to interpret these tests."
Eat and Be Wary

* An estimated 12 million Americans�including four million children�have food allergies.
* From 1997 to 2007, the percentage of U.S. children with a reported food or digestive allergy increased from 3.3% to 3.9%.

"Are these blood tests being overused? Possibly. Misinterpreted? Absolutely," says Robert Wood, director of Pediatric Allergy and Immunology at Johns Hopkins Hospital, who is part of a task force writing guidelines for diagnosing and managing food allergies. "A lot of these kids truly have food allergies, just not to all the foods that they are being told they have allergies to."

In some cases, the blood or skin tests reveal antibodies to a food that the child has already been eating without problems. It's easy to dismiss those results. It's harder to know what to make of IgE antibodies to foods a child hasn't yet tried. Children with eczema, like Grayson Grebe, tend to have IgE antibodies to a large number of foods, and it can be difficult to sort out which really do pose problems.

Allergy experts can make some guesses about the likelihood of a reaction based on test results, and they are starting to establish cutoff thresholds. In a skin-prick test, for example, a wheal smaller than 5 millimeters in diameter indicates a slim chance of a real allergy, says Dr. Sampson; a wheal greater than 10 millimeters is generally a good chance.

In blood tests, some research suggests that IgE antibody levels higher than 7 KUa/L to egg, 15 to milk and 14 to peanut are highly predictive of an allergic reaction. But some people have allergic reactions at lower levels, too.

And none of those tests can predict how severe an allergic reaction might be. A person with a peanut allergy might react with a tingle in the mouth, a case of hives or a full-blown anaphylaxis, depending on many variables, including how much peanut they ingested and in what form.

Complicating diagnoses further is the fact that food allergies are a moving target as children get older. It's estimated that 80% of children with allergies to milk, eggs, wheat, diary and soy outgrow them, usually by about age 5. But only about 20% of those with allergies to peanuts, tree nuts and shellfish do. And for reasons not fully understood, some people can develop allergies later in life to foods they've previously tolerated, particularly shellfish.

Doctors can get some clues to an allergy's progression by monitoring skin and/or blood tests regularly. And when IgE levels have been dropping consistently, or were never high to begin with, some may suggest trying a food challenge, usually done in a hospital or specially equipped doctor's office, where help is immediately available in case of a bad reaction.
The Food Challenge

For some families, deliberately exposing a child to food they have scrupulously avoided for years is simply not worth the risk. But for those who have had to severely restrict a child's diet, restoring some food groups can be life-changing.

"There is a kind of post-traumatic stress syndrome that happens after a bad allergic reaction," says Dan Atkins, head of outpatient pediatrics at National Jewish Health. "But the payoff in successful food challenge is huge."

"I thought it was pretty entertaining," says 15-year-old Alex Simko of Geneva, Ill., who did a four-hour food challenge with hard-boiled eggs last year after avoiding them for 12 years. She made faces throughout because she hated the taste of eggs. But she didn't have an allergic reaction�and allowing eggs into her diet has opened up a world of baked goods ("doughnuts!") she previously had to avoid.

Some other kids aren't as sanguine. Having been told all his life to avoid eggs all his life, 4-year old Kevin Stokes refused to try them during a food challenge at Duke University Medical Center last year. "He freaked out," says Jodi Stokes, who holds out hope that he will try again. In the meantime, he is still allergic to peanuts, tree nuts and milk, so they have the same rule that many allergy families have about scrutinizing food labels: "If you can't read it, you can't eat it."

A new kind of blood test could someday help doctors zero in more definitively on who is most likely to have allergic reaction to foods. Phadia AB, a maker of allergy tests, has developed a test, called Component-Resolved Diagnostis (CRD) that can determine which molecule within a food is sparking the antibody reaction. In the peanut, for example, only three of 14 different molecules are associated with anaphylaxis-causing reaction, according to the company. CRD has not yet been submitted for approval by the Food and Drug Administration, but it is in use in Europe.

In the Manchester study, for example, the researchers found that almost all of the children who were highly allergic to peanuts reacted to a specific protein call Ara h 2.

Knowing more about what specific molecules cause allergic reactions could help scientists understand more about the severity of allergic reactions, and someday help efforts to develop treatments to trick the immune system into behaving differently. In the meantime, parents with allergic children are often left walking a fine line, between taking potential life-threatening risks seriously, and not overreacting to tests that may not reflect a child's actual risk.