Controversial practices in allergy.

The clinical practice of modern allergy has a sound foundation in a scientific understanding of the pathogenesis of hypersensitivity disorders. However, several practices continue to be regarded as controversial. Controlled studies have failed to establish the effectiveness of intracutaneous or low-level modified radioallergosorbent titration as a guide to immunotherapy. In addition, controlled studies do not support the clinical usefulness of provocative subcutaneous or sublingual testing procedures of the leukocytotoxicity assay for the diagnosis of food allergy. Food additives have not been clearly shown to influence hyperkinesis, and autogenous urine immunotherapy is without supporting evidence of effectiveness and is potentially harmful. Since allergic diseases are common and the economic impact of medical care for these patients is great, it is important for physicians to understand the basis for these procedures and to advise patients accordingly.