IMAGINARY CONDITIONS

Toxic Mold Syndrome, another fad

Home
Toxic Mold Syndrome, another fad
New Page Title

This is not to argue that there aren’t some genuine cases, but rather to point out that most cases are for those who have the imaginary condition syndrome, and at best theirs is an allergic reaction.

Existence of toxic mold syndrome questioned

 

 

By Will Boggs, MD Fri Oct 14, 3:33 PM ET,  Reuters News Service

 

NEW YORK (Reuters Health) - Mold and dampness can cause coughing and wheezing, but there is little evidence to support the existence of the so-called toxic mold syndrome, according to a report by researchers at the Oregon Health Sciences University in Portland.   Toxic mold syndrome -- illnesses caused specifically by exposure to mold -- continues to cause public concern despite a lack of evidence that supports its existence, researchers explain in the September issue of the Annals of Allergy, Asthma & Immunology. Several critical reviews have failed to find scientific support for toxic effects from breathing in mold spores as a viable mechanism of human disease, they add.

 

Dr. Barzin Khalili and Dr. Emil J. Bardana, Jr. describe the clinical characteristics of 50 patients with complaints of illness they attributed to mold exposure in their home or workplace. The patients had been referred by a defense attorney in a civil litigation or by insurance adjusters representing worker's compensation agencies.  There was no consistent set of symptoms, the authors report, with patients having an average of more than eight symptoms. Most patients reported a family or personal history of allergy or asthma.  Three quarters of the patients had abnormal physical examination results, the researchers note, with inflammation of the eye or skin and congestion occurring most commonly.  Thirty patients had other non-mold-related illnesses that could explain most, if not all, of their mold-related complaints, the report indicates, and nearly two thirds of the individuals had evidence of a previously diagnosed mood disorder.

 

"In fact," the investigators write, "when the entire history and objective evidence were scrutinized, a number of well-established and plausible diagnoses emerged that explained many, if not all, the complaints."  In a commentary in the journal, Dr. Abba I. Terr from UCSF Medical Center, San Francisco contends that toxic mold disease is "the latest in a series of environmentally related pseudo-illnesses" that include multiple chemical sensitivity, also known as idiopathic environmental intolerance, and chronic fatigue syndrome, which was attributed at one time to infection with Epstein-Barr virus.  "Since these authors have determined that the patients they describe do not have a mold-related disease but are nevertheless seeking compensation for presumed illness through a legal process that has defined it in those terms, toxic mold disease is truly a diagnosis of litigation," Terr concludes.

SOURCE: Annals of Allergy Asthma and Immunology, September 2005.

 

Would be invalids:  about 1/3rd of the people are capable of imaginary illnesses, and of them about 20% have developed major neurotic patterns of behavior associated with the imaginary illnesses.   Thus in a sort of filtering system, the neurotic individuals are much more likely to seek medical intervention and they make up nearly all who seek monetary rewards.  The article above confirms this filtering process. 

 

The issue of mold-caused allergies has no satisfactory answer because of the lack of an accurate method of testing and the number of molds capable of producing illness.  A few clinic cases of illness do not prove the much larger alleged sub-clinical situation.

The article above calls to question the self-diagnosis of toxic mold syndrome, and concludes that the majority of people examined had allergic reactions (not reactions to toxins).  Allergic reactions are in most instances difficult to pinpoint through observations, or confirm by laboratory tests—jk.

Allergy and "toxic mold syndrome”

Ann Allergy Asthma Immunol. 2005 Feb;94(2):234-9.

Edmondson DA, Nordness ME, Zacharisen MC, Kurup VP, Fink JN.

Division of Allergy/Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin 53201, USA. dedmonds@mcw.edu

BACKGROUND: "Toxic mold syndrome" is a controversial diagnosis associated with exposure to mold-contaminated environments. Molds are known to induce asthma and allergic rhinitis through IgE-mediated mechanisms, to cause hypersensitivity pneumonitis through other immune mechanisms, and to cause life-threatening primary and secondary infections in immunocompromised patients. Mold metabolites may be irritants and may be involved in "sick building syndrome." Patients with environmental mold exposure have presented with atypical constitutional and systemic symptoms, associating those symptoms with the contaminated environment. OBJECTIVE: To characterize the clinical features and possible etiology of symptoms in patients with chief complaints related to mold exposure. METHODS: Review of patients presenting to an allergy and asthma center with the chief complaint of toxic mold exposure. Symptoms were recorded, and physical examinations, skin prick/puncture tests, and intracutaneous tests were performed. RESULTS: A total of 65 individuals aged 1 1/2 to 52 years were studied. Symptoms included rhinitis (62%), cough (52%), headache (34%), respiratory symptoms (34%), central nervous system symptoms (25%), and fatigue (23%). Physical examination revealed pale nasal mucosa, pharyngeal "cobblestoning," and rhinorrhea. Fifty-three percent (33/62) of the patients had skin reactions to molds.[1]  CONCLUSIONS: Mold-exposed patients can present with a variety of IgE- and non-IgE-mediated symptoms. Mycotoxins, irritation by spores, or metabolites may be culprits in non-IgE presentations; environmental assays have not been perfected. Symptoms attributable to the toxic effects of molds and not attributable to IgE or other immune mechanisms need further evaluation as to pathogenesis. Allergic, rather than toxic, responses seemed to be the major cause of symptoms in the studied group.

 

Inhalational mold toxicity: fact or fiction? A clinical review of 50 cases

Ann Allergy Asthma Immunol. 2005 Sep;95(3):239-46.

Khalili B, Bardana EJ Jr.

Oregon Health Sciences University, Portland, Oregon 97239, USA. barzinkhalili@yahoo.com

BACKGROUND: Three well-accepted mechanisms of mold-induced disease exist: allergy, infection, and oral toxicosis. Epidemiologic studies suggest a fourth category described as a transient aeroirritation effect. Toxic mold syndrome or inhalational toxicity continues to cause public concern despite a lack of scientific evidence that supports its existence. OBJECTIVES: To conduct a retrospective review of 50 cases of purported mold-induced toxic effects and identify unrecognized conditions that could explain presenting symptoms; to characterize a subgroup with a symptom complex suggestive of an aeroirritation-mediated mechanism and compare this group to other diagnostic categories, such as sick building syndrome and idiopathic chemical intolerance; and to discuss the evolution of toxic mold syndrome from a clinical perspective. METHODS: Eighty-two consecutive medical evaluations were analyzed of which 50 met inclusion criteria. These cases were critically reviewed and underwent data extraction of 23 variables, including demographic data, patient symptoms, laboratory, imaging, and pulmonary function test results, and an evaluation of medical diagnoses supported by medical record review, examination, and/or test results. RESULTS: Upper respiratory tract, lower respiratory tract, systemic, and neurocognitive symptoms were reported in 80%, 94%, 74%, and 84% of patients, respectively. Thirty patients had evidence of non-mold-related conditions that explained their presenting complaints. Two patients had evidence of allergy to mold allergens, whereas 1 patient exhibited mold-induced psychosis best described as toxic agoraphobia. Seventeen patients displayed a symptom complex that could be postulated to be caused by a transient mold-induced aeroirritation. CONCLUSION: The clinical presentation of patients with perceived mold-induced toxic effects is characterized by a disparate constellation of symptoms. Close scrutiny revealed a number of preexisting diagnoses that could plausibly explain presenting symptoms. The pathogenesis of aeroirritation implies completely transient symptoms linked to exposures at the incriminated site. Toxic mold syndrome represents the furtive evolution of aeroirritation from a transient to permanent symptom complex in patients with a psychogenic predisposition.  In this respect, the core symptoms of toxic mold syndrome and their gradual transition to chronic symptoms related to nonspecific environmental fragrances and irritants appear to mimic what has been observed with other pseudodiagnostic categories, such as sick building syndrome and idiopathic chemical intolerance.



[1]  Positive IgE skin tests do not prove the clinical case.  Positive IgE results are only weakly associated with clinical symptoms—jk