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Howard S. Rubenstein, MD
Harvard University University Health Services Cambridge, Mass

JAMA. 1980;244(15):1673.

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In Reply.—

A patient with pure, chronic, and severe hay fever could be advised to receive immunotherapy not on grounds that asthma would otherwise develop, but because the therapy might alleviate the hay fever. Dr Tuft apparently does not think this is a sufficiently good reason. Even so, his textbook does not support his assertion with data. His forthcoming article seems to study concurrent ragweed hay fever and asthma, a different problem, for which Bruce et al¹ found no benefit from immunotherapy.

If a pediatric allergist studied children at two points in time, however well controlled the experiment, the study would not answer the question whether hay fever in the child treated by immunotherapy prevents asthma in the adult. Still, some pediatric allergists apparently believe that the young adolescents who emerge from their care symptom free forever remain so. However, many such patients as adults end up in a . . . [Full Text PDF of this Article]

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