Profile of patients with chemical injury and sensitivity

Abstract:

Patients reporting sensitivity to multiple chemicals at levels usually tolerated by the healthy population were administered standardized questionnaires to evaluate their symptoms and the exposures that aggravated these symptoms. Many patients were referred for medical tests. It is thought that patients with chemical sensitivity have organ abnormalities involving the liver, nervous system (brain, including limbic, peripheral, autonomic), immune system, and porphyrin metabolism, probably reflecting chemical injury to these systems.

Laboratory results are not consistent with a psychologic origin of chemical sensitivity. Substantial overlap between chemical sensitivity, fibromyalgia, and chronic fatigue syndrome exists: the latter two conditions often involve chemical sensitivity and may even be the same disorder. Other disorders commonly seen in chemical sensitivity patients include headache (often migraine), chronic fatigue, musculoskeletal aching, chronic respiratory inflammation (rhinitis, sinusitis, laryngitis, asthma), attention deficit, and hyperactivity (affected younger children). Less common disorders include tremor, seizures, and mitral valve prolapse.

Patients with these overlapping disorders should be evaluated for chemical sensitivity and excluded from control groups in future research. Agents whose exposures are associated with symptoms and suspected of causing onset of chemical sensitivity with chronic illness include gasoline, kerosene, natural gas, pesticides (especially chlordane and chlorpyrifos), solvents, new carpet and other renovation materials, adhesives/glues, fiberglass, carbonless copy paper, fabric softener, formaldehyde and glutaraldehyde, carpet shampoos (lauryl sulfate) and other cleaning agents, isocyanates, combustion products (poorly vented gas heaters, overheated batteries), and medications (dinitrochlorobenzene for warts, intranasally packed neosynephrine, prolonged antibiotics, and general anesthesia with petrochemicals).

Multiple mechanisms of chemical injury that magnify response to exposures in chemically sensitive patients can include neurogenic inflammation (respiratory, gastrointestinal, genitourinary), kindling and time-dependent sensitization (neurologic), impaired porphyrin metabolism (multiple organs), and immune activation.

 

Source: Ziem G, McTamney J. Profile of patients with chemical injury and sensitivity. Environ Health Perspect. 1997 Mar;105 Suppl 2:417-36. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1469804/  (Full article)

 

Fatigue syndromes revisited: the possible role of porphyrins

Abstract:

The author sees many patients with chronic oral problems of unknown etiology. It has been noticed that many of these patients also have complex medical histories. Fatigue and pain are two of the most common features observed. Some, but not all, also have other definitive medical diagnoses. Those patients with appropriate symptoms have been tested for porphyrins and porphyrin enzyme activity. Advances in molecular biology have led to the availability of a number of porphyrin enzymes for routine testing. The results are interesting and suggest abnormal porphyrin metabolism may be more prevalent than is currently thought.

 

Source: Downey DC. Fatigue syndromes revisited: the possible role of porphyrins. Med Hypotheses. 1994 May;42(5):285-90. http://www.ncbi.nlm.nih.gov/pubmed/7935069