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Making sick children better.

Dr John Chapman FRCPCH

Consultant Paediatrician (NHS & Private)

 General Paediatrics, Asthma and Allergy

Case Studies in Allergy

Tom, Dick and Harry

Tom is 10 years old eats a piece of cake with some peanut in it. He feels sick, vomits and gets swollen painful lips. It is not clear how much peanut there was in the cake.

Tom has never eaten peanut before and has recently started to have problems with hay fever. He has had asthma for three years

Tom has never eaten peanut before and has recently started to have problems with hay fever. He has had asthma for three years

Tom attends his allergist and has a skin prick test of 8 mm.

Tom is diagnosed with peanut allergy

Tom is told to avoid peanut and to cautious about other nuts

Tom is given an adrenaline auto injector, some Cetrizine (antihistamine) and an emergency plan.

Tom chooses to avoid all nuts (and coconut) and is fearful about eating outside of home.

Dick is 10 years old eats a piece of cake with some peanut in it. He feels sick, vomits and gets swollen painful lips. It is not clear how much peanut there was in the cake.

Dick has never eaten peanut before and has recently started to have problems with hay fever. He has had asthma for three years

Dick attends his allergist and has a skin prick test of 8 mm.

Dick is diagnosed with peanut allergy

Dick goes on to have allergen component testing using the ISAC 112 chip.

Dick finds out the he is allergic to the peanut protein Ara h1 and grass pollen protein. These proteins are unrelated.

Dick learns that Ara h1 is associated with significant reactions so he is very strict about avoidance and carries his AAI with him everywhere. His allergist advises him not to undergo a food challenge as he is likely to have a significant reaction.

Harry is 10 years old eats a piece of cake with some peanut in it. He feels sick, vomits and gets swollen painful lips. It is not clear how much peanut there was in the cake.

Harry has never eaten peanut before and has recently started to have problems with hay fever. He has had asthma for three years

Harry attends his allergist and has a skin prick test of 8 mm.

Harry is diagnosed with peanut allergy

Harry goes on to have allergen component testing using the ISAC 112 chip.

Harry finds out the he is allergic to the peanut protein Ara h8 And birch tree pollen protein Bet v1.

These are both PR10 plant defence proteins. Harry has a Pollen Fruit Syndrome including a peanut Oral Allergy Syndrome.

Harry chooses to undergo a peanut challenge in hospital and eats 6 peanuts with some mouth itching at the final stage.

Harry is reassured that his peanut allergy is not life threatening. Harry chooses to avoid peanut but not carry his AAI. Harry eats out without undue concern as he knows that he will not have a serious reaction to peanut contamination.

Harry and Dick think that Knowledge is power.

Private Allergy Reviews

How to book an Private allergy review.

First we need to talk. I need to understand your child's allergic illnesses, what is in their environment and what you think triggers your problems. This is called an allergy focussed history. We can do this ideally face to face so that I can examine them too. If a face to face meeting is not possible then we can do it by phone, Skype or FaceTime. The cost to you will be the same. 

Second we need to decide what type of testing would give us the best answers. 

If the history is clear and reasonably straightforward then Skin Prick Testing is ideal. It is well tolerated by children of all ages and I can usually get it done within a week if that suits you. The test results are ready in about 15 minutes and we can test almost anything using our allergen solution or the prick-prick method. If you have a concern about an unusual substance then bring some with you. We have had everything from Green Mussels to Honeysuckle used in this way. Obviously you will have to come to clinic to do this!

Skin Prick Testing would be the preferred method for most babies.

However if the history is unclear, or you have multiple allergies such as (Pollen Fruit Syndrome) or if you think that you child will not tolerate skin testing, or you are unable to attend in person, then we can now do ISAC 112 testing at home.

Book an Allergy Review

The ISAC 112 test is a bioarray chip. It tests for 112 components of about 50 foods, animals or environmental allergens. A drop of you blood goes on the chip and reacts with the reagents on it. It is then read by a computer. The results are accurate and reliable. It is the same machine as the NHS labs use. It is PROPER specific IgE testing. Do not get it mixed up with IgG testing, which I do not recommend.

View a sample ISAC 112 report here

How do I do ISAC 112 testing at home? Watch the video!

After our initial discussion, I will post you a sample taking kit which contains full clear instructions and everything that you will need. You prick you child's finger with the lancet in the kit put literally a few drops of blood in the TDL Tiny tube.

Then label the tubes, put them in the container provided and post them off to the lab using the envelope in the kit.

When the results are available, we can arrange to meet or chat again at your convenience to go through the implications of the results.

How Much Will it Cost

How much will it cost?

Both types of review include an initial consultation, the tests and a follow up review to discuss the results. I will write to you a letter at the end of the process and copy this to your GP with recommendations for your treatment plan.

An SPT allergy review will cost £400

An ISAC 112 allergy review will cost £600

If you want additional blood component testing of allergens not included in ISAC, then this will incur an additional charge. Contact me and we can chat about it. I will never hit you with an unexpected or hidden charge. see what included in ISAC 112 here.

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If you want personalised advice then come and see me. Book a Private Clinic Appointment.

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