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Allergy Frontiers: Diagnosis and Health Economics pp 423–451Cite as

State of the Art: Multiple Chemical Sensitivity

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Part of the book series: Allergy Frontiers ((ALLERGY,volume 4))

The ‘multiple chemical sensitivity syndrome’ (MCS) is defined descriptively as a (1) chronic condition (2) with symptoms that recur reproducibly (3) in multiple organ systems (4) in response to low levels of exposures (5) to multiple unrelated chemicals and which (6) improve or are resolved when incitants are removed. Patients' symptom profiles indicate that two different symptom clusters exist with predominant ‘central’, to the central nervous system (CNS)-related, and ‘peripheral’, mucosa-associated chemical sensitivities. The latter is identical with occupational rhinitis and asthma. Thus, an MCS diagnosis should only be made in cases with predominant exposure-related, non-specific complaints of the CNS. Our understanding of the aetiology and pathogenesis of MCS is still incomplete. There is sufficient evidence that psychological, but not neurophysiologic or biological factors contribute to the induction and perpetuation of MCS. There are no specific laboratory tests to establish an MCS diagnosis. Differential diagnostic procedures encompass a clarification analogous to chronic fatigue syndrome (CFS) standards, evaluation of additional symptoms and a psychiatric evaluation. At present, no evidence-based treatment options exist.

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Authors and Affiliations

  1. Department of Psychotherapy and Psychosomatic Medicine, Freiburg University Hospital, Hauptstraße 8, Freiburg, D-79104, Germany

    Michael Lacour & Carl Scheidt

  2. Center for Geriatric Medicine and Gerontology, Freiburg University Hospital, Lehener Straße 88, Freiburg, D-79106, Germany

    Klaus Schmidtke

  3. Department of Rheumatology and Clinical Immunology, Freiburg University Hospital, Hugstetter Straße 55, Freiburg, D-79106, Germany

    Peter Vaith

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  1. Michael Lacour
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  1. Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan

    Ruby Pawankar

  2. Southampton General Hospital, University of Southampton, Tremona Road, Southampton, UK

    Stephen T. Holgate

  3. UMKC School of Medicine, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Lanny J. Rosenwasser

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Lacour, M., Schmidtke, K., Vaith, P., Scheidt, C. (2009). State of the Art: Multiple Chemical Sensitivity. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Diagnosis and Health Economics. Allergy Frontiers, vol 4. Springer, Tokyo. https://doi.org/10.1007/978-4-431-98349-1_24

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