Multiple chemical sensitivities following intolerance to azo dye in sweets in a 5-year-old girl.
(41/104)BACKGROUND: Cases of multiple chemical sensitivities (MCS) have been reported predominantly in adult patients, but pediatric cases have rarely been reported. METHODS: We present a 5-year-old girl who suffered from recurrent reactions accompanied by urticaria, angioedema, headaches, dyspnea, loss of consciousness, and abdominal pain that were not eradicated, but were instead exacerbated, by various treatments with antihistamines and intravenous corticosteroids. Her diet diary revealed that symptoms occurred after ingestion of colorful sweets such as candies and jellybeans. Open challenge tests with food additives and nonsteroidal anti-inflammatory drugs (NSAIDs) were performed after elimination of these items. Skin prick tests using additives and NSAIDs, which were dissolved in saline, and prick- prick tests using candies and jellybeans, were carried out. RESULTS: Open challenge tests with Tartrazine, aspirin and acetaminophen were positive, whereas skin prick tests using additives and NSAIDs and prick-prick tests using candies and jellybeans were all negative. Consequently, intolerance to azo dyes and NSAIDs such as aspirin was diagnosed. However, she appeared to react to multiple chemical odors such as those of cigarette smoke, disinfectant, detergent, cleaning compounds, perfume, and hairdressing, all while avoiding additives and NSAIDs. On the basis of her history and the neuro-ophthalmological abnormalities, a diagnosis of severe MCS was made and she was prescribed multiple vitamins and glutathione. CONCLUSIONS: The present results suggest that in pediatric MCS, food and drug additives containing azo dyes might play important roles as elicitors. (+info)
Classification of patients complaining of sick house syndrome and/or multiple chemical sensitivity.
(42/104)Sick house syndrome (SHS) is a Japanese concept derived from sick building syndrome (SBS), however SHS includes a broader scope of sickness than does SBS. Symptoms of SHS/SBS disappear after leaving the sick house/building, while symptoms of multiple chemical sensitivity (MCS) are elicited by the chance of chemical exposure after leaving the sick house/building. To establish the concept of SHS, we propose to introduce a new classification for SHS. A total of 214 patients complaining of SHS and/or MCS were independently classified using a new classification by clinical ecologists who are experienced physicians with expert knowledge of clinical ecology and general physicians according to disease pathogenesis from clinical records. The classification is as follows: type 1 (symptoms of chemical intoxication), type 2 (symptoms developed possibly due to chemical exposure), type 3 (symptoms developed not because of chemical exposure but rather because of psychological or mental factors), and type 4 (symptoms developed due to allergies or other diseases). The agreements on the classification made by clinical ecologists and general physicians reached 77.1% (Cohen's kappa=0.631), suggesting that this new classification was both apt and accurate. Relations between SHS and allergy/MCS were also studied. The cases classified as SHS type 4 more frequently had allergic past histories than did other types. The proportion of possible MCS cases was higher in the chemical induced SHS group (types 1 and 2) than in other types among male patients. For the universal use in clinical practice, it is necessary to prepare helpful diagnostic criteria of this SHS classification based on pathogenesis and carry our study forward all over the country. (+info)
Volatile organic compounds contribute to airway hyperresponsiveness.
(43/104)BACKGROUND: Volatile organic compounds (VOCs) in concentrations found in both the work and home environments may influence lung function. We investigated the prevalence of airway responsiveness in workers exposed to VOCs. METHODS: We used allergic skin tests, nonspecific airway hyperresponsiveness testing and questionnaires to study twenty exposed workers and twenty-seven control subjects. Atopy was defined as a reactor who showed > 3+ response to one or more allergens on the skin prick tests. Airway hyperresponsiveness (BRindex) was defined as log [% fall of FEV1/log (last concentration of methacholine) +10]. RESULTS: The VOC exposed workers, in comparison with the control subjects, tended to have a higher BRindex (1.19 +/- 0.07 vs. 1.15 +/- 0.08, respectively). Workers exposed to VOCs with atopy or smoker, as compared with the workers exposed to VOCs with non-atopy and who were non-smokers and the control subjects with non-atopy and who were non-smokers, had a significantly higher BRindex (1.20 +/- 0.05 vs. 1.14 +/- 0.06 vs. 1.10 +/- 0.03, respectively p < 0.05). The BRindex was not correlated with atopy, the smoking status or the duration of VOC exposure. CONCLUSIONS: These findings suggest that VOCs may act as a contributing factor of airway hyperresponsiveness in workers exposed to VOCs. (+info)
The association or otherwise of the functional somatic syndromes.
(44/104)OBJECTIVE: To review the evidence for overlap in the phenomenology of the Functional Somatic Syndromes (FSS). The FSS show considerable comorbidity, leading some to suggest they may be aspects of the same disorder. METHODS: We conducted a selective review of peer-reviewed articles on the co-occurrence of FSS symptoms and diagnoses. RESULTS: Considerable evidence of overlap was found at the level of symptoms, diagnostic criteria, and clinical diagnoses made. CONCLUSIONS: Phenomenological commonalities support a close relationship between the FSS, although differences remain in other domains. Whether the FSS may best be considered the same or different will depend on the pragmatics of diagnosis. (+info)
Living with toxic poisioning.
(45/104)In 1991 I was working as an administration officer at a school in North Queensland. I worked with two other women in a very small office and there were three other offices nearby, each with one person in them. The education department decided to put down new flooring around these offices, down the adjoining stairway and along the adjoining hallway. The new flooring was made up of coloured chips spread over the floor coated by a two part resin. At the time the flooring was being laid, the weather was very wet and humid. The two part coating would not set. It was soft to touch and smelt toxic. After complaints from office staff to the education department, the floor was patched up. This process happened about three times over a 3 year period. (+info)
Neuropsychological and positron emission tomography correlates in idiopathic environmental intolerances.
(46/104)OBJECTIVES: It has been hypothesized that people with subjective hypersensitivity to chemicals may indeed suffer from neuronal damage due to widely distributed environmental toxins and that such deficits of diagnostic importance can be demonstrated with the help of functional neuroimaging even in single cases. In this study, a small group of well-characterized patients with idiopathic environmental intolerance were examined in order to identify such changes. METHODS: Twelve patients with idiopathic environmental intolerance were investigated neuropsychologically and underwent cerebral F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET). The imaging results were compared with findings from 17 healthy controls. RESULTS: Six patients showed deficits in verbal learning and memory, three of them also had a reduced information processing speed. In the individual analyses, 11 patients showed normal cerebral glucose metabolism. In the group analysis of the patients, no areas with significantly reduced glucose metabolism could be found. CONCLUSIONS: No consistent pathological cognitive performance and functional imaging pattern was found. It appears premature to claim specific neuropsychological or neuroimaging findings characteristic of idiopathic environmental intolerance. Therefore cerebral F-18 FDG PET should not be used to corroborate or rule out suspected idiopathic environmental intolerance, a syndrome whose potential biological underpinnings still need to be clarified. (+info)
Capsaicin provocation using two different inhalation devices.
Anaesthesia for patients with idiopathic environmental intolerance and chronic fatigue syndrome.