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.
Medical Toxicology, Evanston Northwestern Healthcare OMEGA, Glenbrook Hospital, 2150 Pfingsten Road, Suite 3000, Glenview, IL 60025, USA. Jleikin@enh.org
Jerrold B
JB
Leikin
Mark B
MB
Mycyk
Sean
S
Bryant
Kirk
K
Cumpston
Stephen
S
Hurwitz
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