special subjects
Idiopathic Environmental Intolerance
Symptoms and Signs
Symptoms of idiopathic environmental intolerance (eg, palpitations, chest pain, sweating, shortness of breath, fatigue, flushing, dizziness, nausea, choking, trembling, numbness, coughing, hoarseness, difficulty concentrating) are numerous and usually involve more than one organ system. Most patients present with a long list of suspected agents, self-identified or identified by a physician during previous testing. Such patients often go to great lengths to avoid these agents by changing residence and employment, avoiding foods containing “chemicals,” sometimes wearing masks in public, or avoiding public settings altogether. Physical examination is characteristically unremarkable. 