化学物質過敏症可能性例の検討 : アレルギーの観点から  [in Japanese] CLINICAL ASPECTS OF PATIENTS WITH MCS : FROM THE STANDPOINT OF ALLERGY  [in Japanese]

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Author(s)

    • 長谷川 眞紀 Hasegawa Maki
    • 独立行政法人国立病院機構相模原病院臨床環境医学センター National Hospital Organization, Sagamihara National Hospital
    • 大友 守 Ohtomo Mamoru
    • 独立行政法人国立病院機構相模原病院臨床環境医学センター National Hospital Organization, Sagamihara National Hospital
    • 秋山 一男 Akiyama Kazuo
    • 独立行政法人国立病院機構相模原病院臨床研究センター National Hospital Organization, Sagamihara National Hospital

Abstract

【背景】"シックハウス症候群"は室内環境要因-アレルゲン, 病原菌, 揮発性化学物質など-によって惹起される健康被害と考えられているが, その病態, 病因についてはまだ確立していない. また"シックハウス症候群"は微量の揮発性化学物質によって起こる化学物質過敏症と重なる部分が大きいと考えられる. 【方法】我々の施設を訪れた患者の中から, 4つの仮のクライテリア((1)化学物質への曝露歴, (2)多臓器の症状, (3)症状を説明するような他の疾患の除外, (4)慢性の症状)によって, 化学物質過敏症の可能性例を選び出し, その臨床像を調べた. 【結果】130名余りの患者のうち, 50名が可能性例と判定された. 女性が38名, 男性が12名, 年齢は15歳から71歳であった. そのうち42名(84%)の患者がなんらかのアレルギー性疾患の既往, または合併を持っていた. これは本邦一般人口中のアレルギー疾患の有病率よりずっと大きい. アレルギー疾患の中ではアレルギー性鼻炎が最も多かった. 総IgE値は比較的低値で32名(64%)が200IU/ml未満であった. 抗ホルムアルデヒドIgE抗体が陽性の患者はいなかった. 化学物質負荷試験後の末梢血ヒスタミン遊離反応では, reactivityもsensitivityも低下していた. 【結論】化学物質過敏症がアレルギー的機序によって惹起されるとは考えられないが, 化学物質過敏症がアレルギー疾患を持っている患者に起こりやすい, またはアレルギー疾患を顕在化させる可能性が考えられた.

Background : "Sick House Syndrome" is thought to be an illness caused by indoor environments such as allergens, bacteria and chemical compounds. But it is not yet an established clinical entity. "Sick House Syndrome" overlaps in part with Multiple Chemical Sensitivity (MCS) whose symptoms are induced by very small amount of volatile chemical compounds. Methods : We selected possible cases of MCS from patients who visited our specially built facility for " Sick House Syndrome" by tentative criteria as follow. (1)histories of chemical compounds exposure, (2)multi-organ symptoms, (3)exclusion of other disease (s) which may be responsible for symptoms, (4)chronic symptoms. Clinical aspects of the possible cases were examined. Results : Fifty out of about 130 patients were the possible cases of MCS, 38 females and 12 males, aged 15 to 71 years old. Forty two out of 50 patients (84%) had a history and/or a complication of allergic diseases. This rate is much higher than the rate of prevalence of allergic diseases in Japanese population. Allergic rhinitis was the most popular allergic disease in the possible cases. Total lgE values were relatively low, 32 patients (64%) showed the lgE value below 200 IU/'ml. No patients showed anti-formaldehyde lgE antibody. Decreased reactivity and decreased sensitivity of histamine release from peripheral blood were observed after challenge tests with chemical compounds. Conclusion : Allergic reactions can not be the causative mechanism (s) of the MCS, which is induced by multiple and different chemical compounds. Our results, however, suggest that patients having allergic diseases may be easily suffered from MCS or MCS may strengthen symptoms of allergic diseases.

Journal

  • Japanese Journal of Allergology

    Japanese Journal of Allergology 54(5), 478-484, 2005

    Japanese Society of Allergology

References:  11

Cited by:  3

Codes

  • NII Article ID (NAID)
    110002435813
  • NII NACSIS-CAT ID (NCID)
    AN00012583
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0021-4884
  • NDL Article ID
    7377067
  • NDL Source Classification
    ZS9(科学技術--医学--病理学・微生物学・寄生虫学・感染・免疫学・血清学・アレルギー)
  • NDL Call No.
    Z19-32
  • Data Source
    CJP  CJPref  NDL  NII-ELS  J-STAGE 
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