Binkley Karen E
Division of Clinical Immunology and Allergy, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
J Allergy Clin Immunol Pract. 2023 Dec;11(12):3645-3649. doi: 10.1016/j.jaip.2023.08.039. Epub 2023 Sep 3.
Patients with multiple chemical sensitivity, now called idiopathic environmental intolerance, frequently present to clinical immunologists and allergists for diagnosis and treatment. Patients report a plethora of respiratory and multisystem problems attributed to a wide variety of unrelated, otherwise non-noxious, triggers. They may go to extreme, often seemingly bizarre lengths to avoid contact with everyday exposures and may become housebound, unable to work or function socially. Often beginning with exposure to odors, triggers can multiply to involve foods, clothing, medications, and even electromagnetic radiation. The condition cannot be explained by IgE-mediated or other immune processes, and clinical immunologists and allergists may feel unprepared to care for such patients. In this article, a paradigm to understand the probable mechanisms underlying this condition and a practical approach to diagnosis and management will be presented.
患有多重化学物质敏感症（现称为特发性环境不耐受症）的患者经常前往临床免疫学家和过敏症专科医生处进行诊断和治疗。患者报告了大量归因于各种无关的、原本无害的触发因素的呼吸和多系统问题。他们可能会采取极端措施，往往看似怪异，以避免接触日常暴露源，甚至可能足不出户，无法工作或参与社交活动。触发因素通常始于接触气味，随后可能会增多，包括食物、衣物、药物，甚至电磁辐射。这种病症无法用免疫球蛋白E介导的或其他免疫过程来解释，临床免疫学家和过敏症专科医生可能会觉得没有准备好照料这类患者。本文将介绍一种理解该病症潜在机制的范例以及诊断和管理的实用方法。
