| A 4-Year-Old Girl with Manifestations of Multiple Chemical Sensitivities Alan Woolf1,2 1Pediatric Environmental Health Subspecialty Unit and Clinical Toxicology Program, Children's Hospital Boston, Boston, Massachusetts, USA; 2Harvard Medical School, Boston, Massachusetts, USA Abstract
  Children's Hospital Boston Harvard Medical School Multiple chemical sensitivities (MCS) syndrome, also known as idiopathic environmental intolerance, is a controversial diagnosis that encompasses a wide range of waxing and waning, subjective symptoms referable to more than one body system and provoked by exposure to low levels of chemicals, foods, or other agents in the environment. Although MCS has been studied extensively, a unifying mechanism explaining the illness remains obscure, and clinicians are divided as to whether such a medical entity exists separately from psychosomatic syndromes. MCS is an adult diagnosis ; there is little reference to pediatric cases in the scientific literature. In this case from the Pediatric Environmental Health Subspecialty Unit at Boston's Children's Hospital, I present the case of a preschool child who had suffered from milk allergy and poor weight gain as an infant, and then later developed asthma, allergic symptoms, sinusitis, headaches, fatigue, and rashes precipitated by an expanding variety of chemicals, foods, and allergens. I review definitions, mechanisms, diagnostic strategies, and management, and discuss some uniquely pediatric features of MCS as illustrated by this case. Key words: idiopathic environmental intolerance, multiple chemical sensitivities. Environ Health Perspect 108:1219-1223 (2000) . [Online 20 November 2000] http://ehpnet1.niehs.nih.gov/docs/2000/108p1219-1223woolf/ bstract.html Address correspondence to A. Woolf, Regional Center for Poison Control & Prevention, IC Smith Building, Children's Hospital, 300 Longwood Avenue, Boston, Massachusetts 02115 USA. Telephone: (617) 355-5187. Fax: (617) 738-0032. E-mail:woolf@a1.tch.harvard.edu Received 13 July 2000 ; accepted 14 September 2000.
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