Today we returned to Dr Mack for a follow up appointment to check in on Sahil’s progress with peanut oral immunotherapy. Sahil reached his maintenance dose of 2 peanuts in October 2017. To put that in to perspective – he started with a dose equivalent to 1/1000th of a peanut in February 2017.
Since October, Sahil has been eating between 0.5 to 2 peanuts per day. Although his daily maintenance dose is 2 peanuts he had to drop down to 0.5 peanuts for many weeks at at time due to several respiratory illnesses during the fall and winter season.
Before starting OIT, his IgE for peanut was >100 and for soy was 12.9. Last week Sahil had a blood test to check his current IgE levels. His peanut IgE is still >100 and his soy IgE is 10. Since the lab does not report numbers over 100 we did not know his actual IgE for peanut and cannot determine if that value has decreased since starting OIT.
At today’s appointment Sahil had skin prick tests (SPTs) for soy (S), peanut (P), negative (-) and positive (+) controls. Although he eats up to 2 peanuts a day the size of the wheal (red, raised area) is still significant at 10 – 11mm. The wheal size for the soy test was just under 3 mm.
Based on the current IgE level, SPT result and reaction history, Dr Mack said Sahil can go ahead with an oral food challenge for soy at our next appointment.
Sahil eats 2 peanuts a day and a handful of tree nuts a few times a week. At our next appointment we will see if he can tolerate soy too.
This OIT journey is moving us away from fear and towards better living conditions!