As some of you know, my 19 month DS underwent allergy testing early December. They did a skin test and then followed up with the RAST for everything he tested positive for. In the skin test he tested positive for cats, dogs and pecans. They also swabbed his nose and found signs of an allergy there. The allergist told me to give him Nasonex once per day until we saw her again…which is in March. I’ve been on the phone with the nurse and I’m now very confused. The RAST came up negative for everything. So now I’m wondering what was causing the allergy cells in his nose? Was the skin test false? I only gave him the Nasonex for a week because I just don’t like giving him medication. Now that he’s not “allergic” to anything I figured I could formally take him off Nasonex, so I asked the nurse. She told me I needed to keep him on it. I argued with her saying that if he doesn’t have any allergies then why would he need it? She said that the skin test showed that he did have an allergy- so now I’m really confused. I thought the blood test was more accurate. Can anyone help me understand this? The nurse told me that the dr. wants me to keep him on the Nasonex until the next appointment and then I can discuss it with the dr. then…but I’m not satisfied with it. That’s three months of giving him a steroid that I’m not sure he really needs. I’m not going to keep giving it to him, but I’d like to better understand what their logic might be.

By Cocoabutter on Friday, January 5, 2007 - 04:09 pm:

I totally understand your hesitation to use the Nasonex. According to what I have read, there is no conclusive evidence that it is either safe or effective for children under 3. I would ask to talk to the doctor and see if there is any other med that you can give your ds.

As far as the RAST test, I don't know much about it, but the doctor apparently feels that there is a need to proceed with caution and is not willing to rule out any allergies. Here is what I found out about the test from www.labtestsonline.org

How is it used?
The allergen-specific IgE antibody test is done to screen for an allergy (a type I hypersensitivity) to a specific substance or substances when a patient presents with acute or chronic allergy-like symptoms.

The allergen-specific IgE antibody test may be done (instead of other medically supervised allergy testing) when the patient has significant dermatitis or eczema (also a sign of allergies), is taking necessary histamines or anti-depressants that would make other testing more difficult, or if a dangerous allergic reaction could be expected to follow another test.

The allergen-specific IgE antibody test may also be done to monitor immunotherapy or to see if a child has outgrown an allergy, although it can only be used in a general way; the level of IgE present does not correlate to the severity of an allergic reaction, and someone who has outgrown an allergy may have a positive IgE for many years afterward.

What does the test result mean?
Normal negative results indicate that you probably do not have a “true allergy,” an IgE-mediated response to that specific allergen, but the results of allergen-specific IgE antibody tests must always be interpreted and used with caution and the advice of your doctor. Even if your IgE test is negative, there is still a small chance that you do have an allergy.

Elevated results usually indicate an allergy, but even if your specific IgE test was positive, you may or may not ever have an actual physical allergic reaction when exposed to that substance. And the amount of specific IgE present does not necessarily predict the potential severity of a reaction. Your clinical history and other allergy tests, done under close medical supervision, may be necessary to confirm an allergy diagnosis.

By Ginny~moderator on Friday, January 5, 2007 - 06:09 pm:

I strongly suggest you tell the nurse you need to talk to the doctor - in person - about all of your concerns. I agree, continuing the Nasonex in the face of the various negative reports would give me cause for concern also.

I personally do NOT care for communication between doctor and patient being relayed through a nurse - which means question from the patient get filtered through the nurse to the doctor, and filtered again back to the patient. The nurse probably has a list and is calling one patient after another, which has some potential for mixing up patients, patient questions, or doctor responses. I feel that a telephone conversation directly between doctor and patient or a face to face is the only way things like this can be properly handled.