[Eosinophilia-myalgia syndrome associated with 5-OH-tryptophan. Description of a case].
The Authors report a case of eosinophilia-myalgia syndrome in a patient with a history of alcohol abuse, treated with a 5-OH-tryptophan containing drug. As regards the pathogenesis of this "new" clinical syndrome, three major hypotheses can be considered: a) autoimmune, according to which tryptophan could act as an "immunogenic" stimulus, thus evoking a cell-mediated reaction against neuromuscular structures; b) dysmetabolic, that is to say, related to neurotoxic metabolites of tryptophan, which in certain conditions could be degraded by an "alternate" pathway that is normally less operating; c) toxic, which is the most accredited nowadays, according to which there is a toxic factor, perhaps similar to aniline, linked to the process of manufacture and purification of L-tryptophan. In our patient, the drug withdrawal and a therapy with steroids led to the remission of the syndrome.
Farinelli
S
S
II Cattedra Clinica Malattie infettive, Università La Sapienza, Roma.
Mariani
A
A
Grimaldi
A
A
Mariani
M
M
Iannessi
A
A
De Rosa
F
F
D006916:5-Hydroxytryptophan / Q000009:adverse effects*; D000328:Adult; D004802:Eosinophilia / Q000139:chemically induced*; D006801:Humans; D008297:Male; D009135:Muscular Diseases / Q000139:chemically induced*; D010146:Pain / Q000139:chemically induced*; D013577:Syndrome
D006916:5-Hydroxytryptophan
Sindrome eosinofilia-mialgia associata a 5-OH-triptofano. Descrizione di un caso.