title: L-tryptophan-associated eosinophilic fasciitis prior to the 1989 eosinophilia-myalgia syndrome outbreak.
abstract: OBJECTIVE
  To investigate the relationship between L-tryptophan (LT) ingestion and eosinophilic fasciitis (EF) occurring prior to the outbreak of eosinophilia-myalgia syndrome in 1989.
  
  
  METHODS
  Interviews and record reviews of 45 EF case-patients and 126 polymyositis patients (controls) diagnosed prior to 1988.
  
  
  RESULTS
  Nine case-patients (20%) and no controls recalled taking LT before onset of the disease (odds ratio = infinity, 95% confidence interval = 8.3-infinity). Among EF case-patients, LT ingestion was associated with dyspnea.
  
  
  CONCLUSIONS
  LT ingestion was associated with EF prior to the 1989 outbreak of eosinophilia-myalgia syndrome. Lung abnormalities may be a distinguishing feature of LT-mediated illness.
authors.affiliation: NHLBI/CHB, National Institutes of Health, Bethesda, MD 20892.
authors.forename: J R
authors.initials: JR
authors.lastname: Hibbs
authors.forename: B
authors.initials: B
authors.lastname: Mittleman
authors.forename: P
authors.initials: P
authors.lastname: Hill
authors.forename: T A
authors.initials: TA
authors.lastname: Medsger
mesh_terms: D016022:Case-Control Studies; D004196:Disease Outbreaks; D004802:Eosinophilia / Q000139:chemically induced*; D016603:Eosinophilia-Myalgia Syndrome / Q000453:epidemiology* / Q000209:etiology; D005208:Fasciitis / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000175:diagnosis; D014364:Tryptophan / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D014364:Tryptophan