special subjects
Idiopathic Environmental Intolerance
Etiology
Reported triggers for idiopathic environmental intolerance include Alcohol and drugs Caffeineand food additives Carpet and furniture odors Fuel odors and engine exhaust Painting materials Perfume and other scented products Pesticides and herbicides Mobile telecommunication devices Immunologic and nonimmunologic theories have been proposed. They are hampered by lack of a consistent dose response to proposed causative substances; ie, symptoms may not be replicated after exposure to high levels of a substance that previously, at much lower levels, seemed to provoke a reaction. Similarly, consistent objective evidence of systemic inflammation, cytokine excess, or immune system activation in relation to symptoms is lacking. Many physicians consider the etiology to be psychologic, probably a form of Somatic Symptom Disorder . Others suggest that the syndrome is a type of Idiopathic environmental intolerance occurs in 40% of people with Chronic Fatigue Syndrome and in 16% of people with Although measurable biologic abnormalities (eg, decreased levels of B cells, elevated levels of IgE) are rare, some patients have such abnormalities. However, these abnormalities appear without a consistent pattern, their significance is uncertain, and testing for these abnormalities to establish an immunologic basis for the disorder should be discouraged. 