Clinical follow-up and immunogenetic studies of 32 patients with eosinophilia-myalgia syndrome.
31 patients with L-tryptophan-associated eosinophilia-myalgia syndrome (EMS) that developed during the United States outbreak in 1989 were followed up prospectively at a university hospital outpatient rheumatology clinic for 16 to 24 months from the onset of their illness. Another patient with EMS associated with L-tryptophan in 1988 was followed up for 30 months. 93% of the 28 survivors from the 1989 cohort continue to have symptoms affecting 1-4 organ systems (median 3) and 3 have died, so the disorder produces considerable morbidity and mortality. The chronic sequelae most often associated with long-term disability are sclerodermatous skin thickening (54%), sensorimotor polyneuropathy (61%), proximal myopathy (36%), and severe episodic myalgias (64%). Thrombocytopenia developed in 1 patient. HLA-class II typing revealed a non-significant trend towards an association with HLA-DR4. Early therapy with corticosteroids did not seem to prevent the development of chronic manifestations.
Kaufman
L D
LD
Department of Medicine, State University of New York, Stony Brook 11794-8161.
Gruber
B L
BL
Gregersen
P K
PK
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004802:Eosinophilia / Q000139:chemically induced / Q000150:complications* / Q000401:mortality; D004890:Erythema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015804:HLA-DR4 Antigen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced / Q000150:complications* / Q000401:mortality; D010146:Pain / Q000139:chemically induced / Q000150:complications / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D013577:Syndrome; D014364:Tryptophan / Q000009:adverse effects
D015804:HLA-DR4 Antigen; D014364:Tryptophan