Treatment of seasonal allergic rhinitis

EDITOR-Desensitisation for hay fever, using conventional high dose extracts, does work 1 and does modify allergy, as reflected by long term remission of disease for at least three years after treatment, and data indicating reduced progression of hay fever to asthma in children. 2 3 On the other hand, the negative results of the study by Radcliffe et al concerning enzyme-potentiated desensitisation using low dose extracts are convincing and seriously question the use of this alternative treatment. 4 It is unfortunate that your journal cover banner heading did not distinguish the two forms of treatment, with the likely result that general practitioners will be discouraged from referring the small but significant proportion of patients with severe hay fever, unresponsive to nasal corticosteroids and antihistamines, to NHS allergy clinics for consideration of high dose desensitisation.