Eosinophilia-myalgia syndrome associated with L-tryptophan use.
A young, previously healthy woman presented with increasing muscle pain, lower limb swelling, fatigue and eosinophilia. She had consumed L-tryptophan tablets (one to two at night) over the preceding five months for management of her insomnia. Her condition slowly deteriorated and she developed generalised oedema and severe lethargy. A white blood cell count was 21.3 x 10(9)/L with 43% eosinophils (Normal range: 4.0-11.0 x 10(9)/L with 1-6% eosinophils. A biopsy specimen of the deep fascia and gastrocnemius muscle demonstrated fasciitis and myositis. The patient failed to recover after cessation of L-tryptophan use but her condition improved rapidly without significant sequelae after systemic treatment with corticosteroids.
Montanaro
A
A
University of New South Wales School of Pathology, Department of Immunopathology, Prince Henry and Prince of Wales Hospital, Randwick, NSW.
Wakefield
D
D
D000328:Adult; D004802:Eosinophilia / Q000139:chemically induced*; D005208:Fasciitis / Q000139:chemically induced; D005260:Female; D006801:Humans; D009135:Muscular Diseases / Q000139:chemically induced*; D009220:Myositis / Q000139:chemically induced; D010146:Pain; D014364:Tryptophan / Q000009:adverse effects*
D014364:Tryptophan