title: [L-tryptophan-associated chronic eosinophilia-myalgia syndrome treated with cyclosporin].
abstract: After 2 weeks of ingestion of 130 g L-Tryptophan a 52 year old female develops an Eosinophilia Myalgia Syndrome with acute onset of deep venous thrombosis of forearm and possible initial cardiac manifestation featuring intermittent sinustachykardia. This is followed by a severe chronic disease (follow-up 15 months) with diffuse scleroderma and sensomotoric polyneuropathia. The deep muscle biopsy-specimen shows mononuclear infiltration of fascia and interstitial myositis with rare eosinophils. A blood eosinophilia (900/ul) occurs only in the initial acute onset of the illness. Plasma level of Kynurenine is significantly high (4000 pmol/ml), collagenneosynthesis is activated (Procollagen type III peptid 0.927 U/ml). No significant clinical improvement was seen with Acathioprine (100 mg/d) and Prednisolon (40-60 mg/d), after treatment with Ciclosporin scleroderma regresses completely, polyneuropathy is persisting.
authors.affiliation: Klinik für Rheumakranke, Bad Kreuznach.
authors.forename: S
authors.initials: S
authors.lastname: Schubert
authors.forename: F
authors.initials: F
authors.lastname: Trautmann
authors.forename: R
authors.initials: R
authors.lastname: Dreher
mesh_terms: D001706:Biopsy; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D016603:Eosinophilia-Myalgia Syndrome / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D009132:Muscles / Q000473:pathology; D009460:Neurologic Examination / Q000187:drug effects; D014364:Tryptophan / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D016572:Cyclosporine; D014364:Tryptophan
vernacular_title: L-Tryptophan-assoziiertes chronisches Eosinophilie-Myalgie-Syndrom behandelt mit Ciclosporin.