Treatment of hay fever with sodium cromoglycate, hyposensitization, or a combination

In 77 consecutive patients with grass pollen rhinitis as the only allergic disease, treatment with sodium cromoglycate (SCG) nasal spray, hyposensitization with aluminium hydroxide adsorbed extract of grass pollen as perennial treatment, and a combination of the two was compared. Specific serum-IgE, IgG and IgG4 were determined in patients who participated in three consecutive seasons. Significant immune response was found in the hyposensitization group, but not in the group treated with SCG. No correlation between the immunoglobulin responses and the individual symptom and/or medicine scores was found. Symptom and medicine scores were analysed in the 3 weeks with the highest pollen counts each year during 4 consecutive years. Higher scores were found in the group treated with sodium cromoglycate compared with the other two groups, but the difference was only significant for eye and total symptoms in the first season. None of the groups, however, suffered from more than mild to moderate symptoms even in the weeks with peak pollen counts. A significantly larger decrease in the wheals of the skin prick test was shown during hyposensitization than during treatment with SCG. No difference was found in the frequency of patients who became symptom-free or developed pollen asthma.