E3 PreliminaryPreliminaryPEM unclearReview-NarrativePeer-reviewedMachine draft
The sick building syndrome as a part of the autoimmune (auto-inflammatory) syndrome induced by adjuvants.
Israeli, Eitan, Pardo, Asher · Modern rheumatology · 2011 · DOI
Quick Summary
This review paper proposes that sick building syndrome—a collection of unexplained symptoms people develop from spending time in certain buildings—may be part of a larger group of related conditions. The authors suggest that sick building syndrome shares many symptoms with other post-exposure illnesses like Gulf War syndrome and chronic fatigue syndrome, and may all stem from similar immune system problems triggered by specific substances.
Why It Matters
This work is relevant to ME/CFS research because chronic fatigue syndrome is explicitly mentioned as part of the broader functional somatic syndromes framework, and the proposed ASIA classification offers a potential mechanistic bridge connecting ME/CFS to other post-exposure illnesses. If validated, this framework could help clinicians recognize shared pathogenic pathways and improve diagnostic approaches across multiple unexplained illness syndromes.
Observed Findings
- Nine out of ten main symptoms are shared across sick building syndrome, siliconosis, macrophagic myofascitis, Gulf War syndrome, and post-vaccination phenomena.
- Chronic fatigue syndrome is grouped alongside SBS as a functional somatic syndrome with potentially related pathogenic features.
- Shoenfeld and Agmon-Levin's proposed major and minor diagnostic criteria for ASIA may apply across these five conditions.
Inferred Conclusions
- Sick building syndrome should be considered part of the autoimmune/auto-inflammatory syndrome induced by adjuvants (ASIA or 'Shoenfeld's syndrome').
- Common clinical and pathogenic features across these five conditions suggest a shared underlying mechanism despite different triggering exposures.
- The proposed diagnostic criteria for ASIA may aid in diagnosis of SBS and related syndromes, pending further validation.
Remaining Questions
- What are the specific immune mechanisms that link these diverse syndromes together, and are they truly identical or merely overlapping?
- How should the proposed diagnostic criteria for ASIA be validated in prospective clinical studies?
- What role do environmental versus immunological factors play in the development of SBS compared to post-vaccination or post-exposure syndromes?
What This Study Does Not Prove
This review does not prove that SBS is caused by adjuvants or that it shares identical mechanisms with the other conditions mentioned. It is a comparative clinical analysis that identifies symptom overlap, not a mechanistic study demonstrating causation. The proposed diagnostic criteria explicitly require further validation, so their clinical utility remains unestablished.
Tags
Symptom:Cognitive DysfunctionPainFatigueSensory Sensitivity
Method Flag:Exploratory Only
Metadata
- DOI
- 10.1007/s10165-010-0380-9
- PMID
- 21188456
- Review status
- Machine draft
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 10 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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