[L-tryptophan-induced eosinophilia-myalgia syndrome with features of diffuse fasciitis with eosinophilia].
Two female patients developed localized scleroderma on the trunk and the thighs after oral ingestion of L-tryptophan for some years. Both patients reported acute progressive myalgia and weakness of the proximal parts of the extremities. On laboratory evaluation, the leucocyte count was approximately 20,000/mm3, with 38% blood eosinophils in one patient and 53% in the other. The ESR was slightly elevated; electrophoresis and muscle enzymes were normal. Skin and muscle biopsies revealed characteristic features of diffuse fasciitis with eosinophilia. High-dose glucocorticoid therapy resulted in a rapid normalization of the ESR and blood eosinophilia, whereas the scleroderma showed little improvement. The diffuse edema observed in one patient receded within a few days. A correlation between oral ingestion of L-tryptophan and the eosinophilia-myalgia syndrome has been reported recently, and the present case reports must be discussed in the light of this observation. Both patients developed a tryptophan-induced scleroderma-like illness resembling diffuse fasciitis with eosinophilia (Shulman's syndrome).
Senff
H
H
Klinik für Dermatologie und Allergologie, St. Barbara-Hospital, Duisburg.
Köllner
A
A
Engelmann
L
L
Woort-Menker
M
M
Mensing
H
H
Kunze
J
J
D004802:Eosinophilia / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D005208:Fasciitis / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011239:Prednisolone / Q000627:therapeutic use; D014364:Tryptophan / Q000009:adverse effects*
D014364:Tryptophan; D011239:Prednisolone
L-Tryptophan-induziertes Eosinophilie-Myalgie-Syndrom unter dem Bild einer diffusen Fasziitis mit Eosinophilie.