A glimmer of hope

Bryan had an appointment with his allergist at the beginning of August, and for the first time, we came away with some potentially good news. At first, things looked the same- his blood tests all came back with extremely high IgE levels for all of his allergens. (And for those who don't live in this world of allergy terminology, that basically means the likelihood of an allergic reaction is extremely high.) However, our allergist told us that even with the high IgE numbers, she wanted to try a skin test for egg, and if that came back clear, she would want to follow up with an oral food challenge with egg. Wait a second... what did she just say?

Several studies recently have shown that a high percentage of children over the age of 6 who test positive for an egg allergy may still be able to tolerate certain foods that contain egg in them- namely baked goods. Heat has a tendency to denature proteins- basically, change their structure. And when you bake an egg at a temperature of 350 degrees or higher for 30 minutes or more, the protein structure of the egg changes enough that, for some egg-allergic children, their immune system no longer recognizes the protein. Which means that their body no longer attacks that protein- thus, no allergic reaction. So the child is still allergic to egg itself- no omlettes or scrambled eggs. BUT if the egg is in a baked good that has been baked at the proper specifications- again, 350 degrees or higher for 30 minutes or more- the child can eat it safely.

So we did the skin test for egg. (Again for the allergy-uninitiated: the skin test, like the IgE blood test, can tell you the likelihood of an allergic reaction, and it is often used to confirm the results of the blood tests. Neither test, however, can determine the potential severity of a reaction.) I watched my son's skin very carefully for the ten minutes it took for the test to develop, expecting the huge welt to appear as it did the last time we did skin testing... and nothing happened. It came back clear. Wow.

Armed with a negative skin test for egg, our next step is an oral food challenge, scheduled for September 30. Basically, we are going to sit in our allergist's office for at least 2 hours that morning, watching Bryan eat a brownie. A brownie that I will have to make with one egg (and no milk, peanuts, tree nuts, or sesame), baked at 350 degrees or higher for at least 30 minutes.

I'm still kind of trying to process everything. I know that there is a very real possibility that we go into the food challenge, and Bryan could still have an anaphylactic reaction. And to be perfectly honest, not a whole lot will change since, beyond monitoring for his other allergies, the egg specifications are pretty strict. But really, this is the first time in 6 years that we have had anything resembling good news with his allergies. And that glimmer of hope is definitely something I am holding on to.