The case of an adolescent patient presenting with multiorgan symptoms demonstrates the importance of taking into account environmental causes as possible etiologies. Physicians must look at the “elephant in the room”, the environment where children live, for possible causes for multi-organ symptomatology.
A 13-year-old Hispanic female was treated for multiple complaints since age 9, including fast heart palpitations, nosebleeds, headaches, stomach pains, body spasms, and menometrorrhagia. She was treated in a large metropolitan integrated health system by her pediatrician, a cardiologist, a neurologist, and a gastroenterologist and multiple emergency department visits. She had head CTs, X-rays, and abdominal ultrasounds done, all which were normal. At the same time, she lived 30 feet from AllenCo Energy, the operator of an oil production facility in South Los Angeles that halted operations after neighbors complained that fumes were making them sick. When AllenCo closed in 2013, her headaches, nosebleeds, abdominal pains, body spasms, and heart palpitations stopped. However, she developed asthma and nasal allergies. This case illustrates the impact of environmental pollutants on multiple organ systems. This can confuse diagnosticians to look for organspecific etiologies when the culprits are air-borne toxic emissions of petrochemicals that attack the whole organism.