Two Cases of Multiple Chemical Sensitivity Successfully Treated With Kampo Medicine.

CONTEXT: Multiple chemical sensitivity (MCS) is a chronic disorder in which minimal but sustained exposure to particular chemicals causes headaches, vertigo, and multiple other symptoms. Up to 10% of cases are clinically unresponsive to treatment. Kampo medicines include multiple crude components with many applications for organ disorders. OBJECTIVE: The research team aimed to assess the efficacy of goreisan, a Japanese Kampo medicine, for 2 patients diagnosed with intractable cases of MCS. DESIGN: The research team conducted case studies with 2 female patients. SETTING: The study took place at the Kampo clinic in the Department of Gynecology and Obstetrics at the Japanese Red Cross Maebashi Hospital in Maebashi, Gunma, Japan. PARTICIPANTS: The participants were patients at the clinic. INTERVENTION: The first participant received the Kampo formula goreisan for her headaches and keigairengyoto for her mucosal discomfort; the second received goreisan for her headaches and kakkonto to reduce her shoulder-muscle stiffness. The participants received Kampo treatments for one month. OUTCOME MEASURES: The first participant's MCS symptoms were evaluated with the Quick Environment Exposure Sensitivity Inventory questionnaire (QEESI); the second using a numeric rating scale (NRS). RESULTS: After the Kampo treatments, the first participant's QEESI scores for chemical intolerance, symptom severity, and life impact were reduced from 47, 92, and 76 to 37, 39, and 55 points, respectively. The second participant's NRS scores were likewise reduced from 6, 8, and 8 out of 10 to 1, 2, and 1 out of 10. Symptoms were relieved in both patients, and didn't recur. CONCLUSIONS: These results highlight the potential benefits of Kampo medicine for the treatment of intractable MCS. Further investigations will be needed to confirm the mechanism of action, thereby improving the understanding of the effectiveness of Kampo medicine for MCS therapy.

Levetiracetam improves symptoms of multiple chemical sensitivity: Case report.

Multiple chemical sensitivity (MCS) is a disorder of unknown etiology with no effective treatment. Many clinicians accept that a diagnosis of somatic symptoms disorder (SSD) is an appropriate diagnostic category for MCS. We found that administration of levetiracetam improved recurrent symptoms of MCS in a patient. A 23-year-old female presented with recurrent multiple symptoms of musculoskeletal, airway or mucous membrane, heart/chest-related, gastrointestinal, cognitive, affective, neuromuscular, head-related, and skin-related induced by exposure to diesel or gas engine exhaust, tobacco smoke, insecticide, gasoline, paint or paint thinner, cleaning products, fragrances, tar or asphalt, nail polish or hairspray, and new furnishings. Gastrointestinal, cognitive, and skin-related symptoms were precipitated by some food additives. She suffered partial seizures from the age of 17 years, and was diagnosed with right parietal lobe epilepsy. Administration of levetiracetam (250 mg/day) eliminated her MCS symptoms. Levetiracetam reduces the release of presynaptic neurotransmitter including glutamate by binding to presynaptic vesicle protein. A recent study established the presence of glutamatergic overactivation in somatization disorder, a form of SSD. Our case may indicate that a subset of patients with SSD have glutamatergic overactivation, which levetiracetam can normalize. J. Med. Invest. 64: 296-298, August, 2017.

Sensibilidad química múltiple: tratamiento antidepresivo y respuesta clínica en ausencia de trastorno de la personalidad. A propósito de un caso / Multiple chemical sensitivity: antidepressant treatment and clinical response in the absence of personality disorder. A case report

Se define la sensibilidad química múltiple (SQM) como un conjunto de manifestaciones clínicas súbitas ante la exposición a productos químicos a bajas dosis que previamente eran bien toleradas. No existe ninguna prueba analítica, ni exploración complementaria específica de confirmación diagnóstica, y la exploración física es normal. Aunque existe frecuentemente comorbilidad asociada depresiva, en la actualidad la mayoría de los estudios no consideran la SQM como una enfermedad psiquiátrica. No cumple ningún criterio DSM-V o CIE-10, y no se puede incluir como trastorno afectivo, somatomorfo, adaptativo o de la personalidad. Se presenta el caso clínico de una paciente diagnosticada de SQM que ha experimentado importante mejoría de los síntomas propios de este trastorno con medicación antidepresiva -tipo ISRS-, permitiendo entrenamiento conductual de afrontamiento ampliamente considerado contraindicado en estos cuadros (AU)

Multiple chemical sensitivity is defined as a set of sudden clinical manifestations on low level exposure to certain chemical previously well-tolerated products. There is no specific analytical test, or complementary examination to confirm the diagnosis, and the physical examination reveals nothing. Although comorbidity is often associated with depression, at present most studies do not consider multiple chemical sensitivity as a psychiatric illness. It does not fulfil the DSM-V or ICD-10 criteria, and may not be included as an affective, somatoform, adaptive or personality disorder. We present the case of a patient diagnosed with multiple chemical sensitivity who has shown a great improvement in these symptoms associated to the disorder with antidepressant medications - selective serotonin reuptake inhibitors (SSRIs), allowing gradual behavioural training of desensitisation, normally considered to be contraindicated in these diseases (AU)

Cesárea electiva en una paciente con síndrome de sensibilidad química múltiple / Elective cesarean section in a patient with multiple chemical sensitivity syndrome

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Intranasal administration of hyaluronan as a further resource in olfactory performance in multiple chemical sensitivity syndrome.

Multiple chemical sensitivity (MCS) is a relatively common clinical diagnosis in western populations and its symptoms (i.e. dysosmia) are mainly triggered by chemical compounds, such as common odorants. The aim of this study was to test the effect of intranasal administration of hyaluronic acid (HA) on odour threshold and related quality of life in MCS syndrome. Two randomized groups of MCS patients received 30 days’ administration of either a nasal spray (Ialumar®) containing HA [HA group (HAG); n=29] or only physiological solution[PS group (PG); n=30]. Both groups were investigated using the Sniffin’ Sticks test (SST) battery, Questionnaire of Olfactory Disorder (QOD) and Zung Anxiety Scale (SAS) before randomization and after treatment. Paired t-test analysis found a statistically significant reduction in odour threshold (OT) and an improvement in QOD and SAS between pre- and post-treatment results only in the HAG. Furthermore, positive correlations were found between the OT reduction, SAS and QOD improvement. Thus, intranasal administration of HA could be suggested as a further well-tolerated resource in alleviating MCS olfactory discomfort.

Safety survey of intranasal glutathione.

PURPOSE: Glutathione depletion has been documented in several disease states, and exogenous administration has been hypothesized to have therapeutic potential for some conditions. In an effort to reach target tissues of the sinuses and central nervous system (CNS), glutathione is being prescribed as an intranasal spray, although no literature exists to support this mode of administration. The objective of this study was to describe patient-reported outcomes in a population of individuals who have been prescribed intranasal reduced glutathione, (in)GSH. METHODS: A survey was designed to assess individuals' perception of tolerability, adverse events, and health benefits associated with (in)GSH use. Using a pharmacy database, 300 individuals were randomly selected to receive a survey; any individual who had received one or more prescriptions for (in)GSH between March 2009 and March 2011 was eligible for participation. RESULTS: Seventy (70) individuals returned the survey (23.3% response rate) from 20 different states. Reported indications for (in)GSH prescriptions were multiple chemical sensitivity (MCS) (n=29), allergies/sinusitis (n=25), Parkinson disease (PD) (n=7), Lyme disease (n=3), fatigue (n=2), and other (n=10). Of the respondents, 78.8% (n=52) reported an overall positive experience with (in)GSH, 12.1% (n=8) reported having experienced adverse effects, and 62.1% (n=41) reported having experienced health benefits attributable to (in)GSH use. Over 86% of respondents considered the nasal spray to be comfortable and easy to administer. CONCLUSIONS: This is the first study to evaluate patient-reported outcomes among individuals across the country who have been prescribed (in)GSH. The majority of survey respondents considered (in)GSH to be effective and without significant adverse effects. (in)GSH should be further evaluated as a method of treating respiratory and CNS diseases where free-radical burden is a suspected contributor to disease progression.

Living with toxic poisioning.

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.

[An auto-iatrogenic disease]. / Ein auto-iatrogenes Leiden.

A 55-year-old practitioner from an island in the northern sea felt an increasing hypersensitivity of his entire body to various ambient and nutritional allergens and toxics. He started to treat himself with increasing doses of glucocorticoids and moved to a southern climate in Lanzarote and later on to the Swiss mountains in the grisons. On admission to our hospital in December he was in a disastrous psychotic condition, trying to cool down his body by laying naked on his bed at ambient temperatures around the freezing point. He had consumed on average 250 mg prednisone daily over weeks. As we found out later his personal assistant travelling with him was giving him glucocorticoids through the infusion during his hospital stay. He developed a necrotizing septic phlebitis at the infusion site followed by a Pseudomonas aeruginosa sepsis with fatal multiorgan failure. This case illustrates the dangers of self-treatment by doctors and the difficulties in treating a physician.

Successful use of a selective serotonin reuptake inhibitor in a patient with multiple chemical sensitivities.

A 53-year-old man with multiple chemical sensitivities (MCS) received the selective serotonin reuptake inhibitor (SSRI) citalopram for treatment of depression. The treatment was successful and, in parallel to the remission of the depressive symptoms, all MCS symptoms vanished. This suggests that a subgroup of MCS patients may have an atypical depression, that they should be psychiatrically evaluated, and that antidepressive pharmacological treatment may be considered in cases of MCS.