Scleroderma and L-tryptophan: a possible explanation of the eosinophilia-myalgia syndrome.
Scleroderma developed in six women who were taking L-tryptophan. Fasciitis and morphea were most common, but one patient had pleural effusion, hypertension, and signs of cardiac and kidney failure. In five patients the biopsy findings were characteristic of scleroderma; the sixth patient had Crohn's disease and developed fasciitis; her biopsy specimen showed inflammatory arteritis. All patients' conditions improved after cessation of their L-tryptophan intake, initiation of corticosteroid therapy, or both. These findings confirm previous data that show altered tryptophan-kynurenine metabolism in some patients with scleroderma and fasciitis, particularly with tryptophan loading.
Section of Dermatology, Mayo Clinic Scottsdale, Arizona.
S M
SM
Connolly
S R
SR
Quimby
W L
WL
Griffing
R K
RK
Winkelmann
D000328:Adult; D000368:Aged; D004802:Eosinophilia / Q000139:chemically induced* / Q000473:pathology; D005208:Fasciitis / Q000473:pathology; D005260:Female; D006801:Humans; D007737:Kynurenine / Q000652:urine; D008875:Middle Aged; D009220:Myositis / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D012595:Scleroderma, Systemic / Q000139:chemically induced* / Q000473:pathology; D012867:Skin / Q000473:pathology; D013577:Syndrome; D014364:Tryptophan / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism
D007737:Kynurenine; D014364:Tryptophan; D011241:Prednisone