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August 8, 1980

Cromolyn in Combined Gastrointestinal Allergy-Reply

JAMA. 1980;244(6):546-547. doi:10.1001/jama.1980.03310060010005

In Reply.—  We appreciate Dr Salberg's comments regarding our article. His concerns are legitimate, but we think that our criteria for patient selection, our type of challenge, and our documentation of positive responses remain valid. We agree that laboratory documentation of GI hypersensitivity reactions is helpful, but there are no simple laboratory tests that infallibly identify food sensitivity in children.While we agree the double-blind challenges advocated by Bock and colleagues (J Allergy Clin Immunol 62:327, 1978) may establish some types of allergy, we disagree with Dr Salberg's implication that they have supplanted the criteria of Goldman and colleagues1 for GI allergy. A cause-and-effect relationship between antigen exposure and clinical response underlies the concept of allergy. Objectivity and reproducibility are essential, but double-blind challenges provide only objectivity. Having independently inspected each patient's stool samples and having classified the consistency, besides asking for parents' assessments, we believe we were objective. Many