Characteristics of patients with no underlying toxicologic syndrome evaluated in a toxicology clinic.
BACKGROUND
A significant number of patients seek medical evaluation for chronic subjective symptoms they presume to be associated with a single toxic trigger. This report describes our clinic experience with these patients.


METHODS
Twenty patients (of a total of 261 patients) with a mean age of 41 years (median age 42 years; range: 4 to 65 years) were evaluated over an 8 month period. All describe a single past toxic exposure triggering their nonspecific (usually vaguely neurologic) symptoms. Zero of 20 (0%) describe other chemical sensitivities; 2/20 (10%) report ongoing exposure, 18/20 (90%) had a limited exposure dating 1 month to 6 yrs prior to toxicology clinic evaluation; 9/20 (45%) are currently employed; 6/20 (30%) sought alternative medical therapy prior to toxicologist evaluation; 6/20/(30%) have attempted litigation.


CONCLUSIONS
Despite repeatedly normal toxicologic and medical evaluations, all data refuting an underlying toxic cause are not accepted by this series of patients, and their search for a diagnostic linkage persists. Specific toxin identification or treatment for these patients is unlikely to occur.
Leikin
Jerrold B
JB
Medical Toxicology, Evanston Northwestern Healthcare OMEGA, Glenbrook Hospital, 2150 Pfingsten Road, Suite 3000, Glenview, IL 60025, USA. Jleikin@enh.org
Mycyk
Mark B
MB
Bryant
Sean
S
Cumpston
Kirk
K
Hurwitz
Stephen
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D019570:Inhalation Exposure; D007603:Jurisprudence; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000523:psychology; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care; D011041:Poisoning / Q000175:diagnosis* / Q000523:psychology*; D012869:Skin Absorption