A 4-Year-Old Girl with Manifestations of Multiple Chemical Sensitivities

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Grand Rounds in Environmental Medicine

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Environmental Health Perspectives Volume 108, Number 12, December 2000

Children's Hospital Boston

Harvard Medical School

A 4-Year-Old Girl with Manifestations of Multiple Chemical Sensitivities

Alan Woolf1,2

1Pediatric Environmental Health Subspecialty Unit and Clinical Toxicology

Program, Children's Hospital Boston, Boston, Massachusetts, USA; 2Harvard

Medical School, Boston, Massachusetts, USA

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Abstract

Multiple chemical sensitivities (MCS) syndrome, also known as idiopathic

environmental intolerance, is a controversial diagnosis that encompasses a

wide range of waxing and waning, subjective symptoms referable to more than

one body system and provoked by exposure to low levels of chemicals, foods,

or other agents in the environment. Although MCS has been studied

extensively, a unifying mechanism explaining the illness remains obscure,

and clinicians are divided as to whether such a medical entity exists

separately from psychosomatic syndromes. MCS is an adult diagnosis; there is

little reference to pediatric cases in the scientific literature. In this

case from the Pediatric Environmental Health Subspecialty Unit at Boston's

Children's Hospital, I present the case of a preschool child who had

suffered from milk allergy and poor weight gain as an infant, and then later

developed asthma, allergic symptoms, sinusitis, headaches, fatigue, and

rashes precipitated by an expanding variety of chemicals, foods, and

allergens. I review definitions, mechanisms, diagnostic strategies, and

management, and discuss some uniquely pediatric features of MCS as

illustrated by this case. Key words: idiopathic environmental intolerance,

multiple chemical sensitivities. Environ Health Perspect 108:1219-1223

(2000). [Online 20 November 2000]

http://ehpnet1.niehs.nih.gov/docs/2000/108p1219-1223woolf/abstract.html

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Address correspondence to A. Woolf, Regional Center for Poison Control &

Prevention, IC Building, Children's Hospital, 300 Longwood Avenue,

Boston, Massachusetts 02115 USA. Telephone: (617) 355-5187. Fax: (617)

738-0032. E-mail:woolf@...

Received 13 July 2000; accepted 14 September 2000.