Toleranzstörung

Toleranzstörung is a term used in German-language contexts to describe disturbances in the ability to tolerate certain stimuli, substances, or social situations. It is not a single, standardized medical diagnosis, but a descriptive label applied in different disciplines to denote impaired tolerance in a given domain.

Immunology:

In the context of immune tolerance, Toleranzstörung refers to a disruption of the mechanisms by which the immune system learns to distinguish self from non-self. Failures of central tolerance (in the thymus or bone marrow) or peripheral tolerance (regulatory T cells, anergy, or ignorance) can contribute to autoimmune diseases or allergic responses. Clinical manifestations vary by tissue and autoantigens; diagnosis involves serology, clinical signs, and exclusion of other causes. Management focuses on controlling immune activity and protecting organ function, often with immunomodulatory therapies.

Pharmacology:

Drug tolerance is a related but distinct concept where the response to a drug diminishes with repeated exposure, leading to higher doses for the same effect. Mechanisms include receptor downregulation, desensitization, or pharmacokinetic changes. Clinically, tolerance is relevant to analgesics, sedatives, and stimulants. Management includes dose adjustment, drug holidays, rotation to alternative therapies, and non-pharmacological approaches.

Psychosocial and sensory contexts:

The term is sometimes used to describe difficulties in coping with stress, sensory input, or social norms, which can be seen in various neurodevelopmental or psychiatric conditions. In such cases, assessment aims to identify triggers, coping strategies, and supportive interventions.

Because it's not a standardized diagnosis, Toleranzstörung requires careful contextual interpretation by clinicians.