Multiple chemical sensitivity syndrome

Multiple chemical sensitivity syndrome (idiopathic environmental intolerance) is characterized by current, uncertain signs attributed to exposure to chemically unbound substances of low level, commonly found in the environment. The symptoms are numerous and often include a broad system of organs, but the physical results are insignificant. The diagnosis is determined by the exception. Treatment is psychological support and avoidance of perceived stimuli, although these irritants are rarely defined.

[1], [2], [3], [4]

What causes multiple chemical sensitivity syndrome?

There is no universally accepted definition, but a multiple chemical sensitivity syndrome is usually defined as the development of multiple attributes attributed to exposure to any number of identifiable or unidentifiable chemicals (ingested by inhalation, touching or swallowing) in the absence of clinically detectable organ dysfunction or related physical symptoms.

Many immunological and non-immunological theories have been proposed. All these theories are hampered by the lack of a consistent dose response to the proposed causative agents; that is, the symptoms can not be reproduced after exposure to high levels of the substance, which previously - at much lower levels - presumably caused a reaction. Similarly, consistent objective evidence of systemic inflammation, cytokine excess or activation of the immune system in response to symptoms is clearly not enough. Many doctors consider the etiology a psychological - probably a form of somatization disorder. Others suggest that the syndrome is a type of panic attack or agoraphobia. Some aspects of the syndrome resemble the no longer applicable psychological diagnosis of neurasthenia.

Although measurable biological abnormalities (eg, reduced B cell levels, elevated levels of immunoglobulin E) are rare, in some patients such abnormalities are present. However, these deviations appear without a consistent structure, and their meaning remains uncertain.

Symptoms of multiple chemical sensitivity syndrome

Symptoms (eg, tachycardia, chest pain, sweating, shortness of breath, fatigue, flush to the face, dizziness, nausea, choking, trembling, lack of sensitivity, coughing, hoarseness, inability to concentrate) are numerous and usually involve more than one organ system. Most patients are given a long list of suspected substances that are self-identified or identified by the doctor during the previous examination. Such patients often go to great lengths to avoid these substances in the future: they change their place of residence and work, avoid all food products containing "chemicals", sometimes wear masks in public or even stay away from public places. Physical examination produces almost no results.

Diagnosis of multiple chemical sensitivity syndrome

The diagnosis initially involves the elimination of obvious allergies and other known disorders with similar characteristics (eg, atopic disorders such as asthma, allergic rhinitis, food allergies and Quincke's disease). Atopic disorders are excluded on the basis of a typical clinical history, skin nicks, serological tests of a specific immunoglobulin E, or all three points. Consultation with an allergist may be necessary.

[5], [6], [7]

Treatment of multiple syndrome of chemical sensitivity

Despite the vague relationship between cause and effect, treatment is usually aimed at avoiding suspected substances responsible for precipitation, which can be difficult because many of them are ubiquitous. However, it is necessary to prevent social exclusion and costly and highly disruptive means aimed at avoiding possible causes of the disease. Psychological evaluation, as well as interference, can help, but very many patients resist this. However, the essence of this approach is not to demonstrate that the reason is psychological, but rather to help patients cope with their ailment.