title: Eosinophilia, myopathy, and neuropathy in a patient with repeated use of L-tryptophan.
abstract: In October of 1989, a clustering of cases with eosinophilia lead to the identification of a new syndrome: The eosinophilia myalgia syndrome associated with the use of an L-tryptophan product. Two years before the possible causal relationship between the use of L-tryptophan and the syndrome was described, we treated a patient with eosinophilia, severe neuropathy and disabling myopathy. Immunosuppressive therapy was required to treat the first flare of her disease. With reexposure to L-tryptophan, she relapsed and recovered when L-tryptophan was discontinued. Interestingly, she tolerated a third exposure to L-tryptophan without clinical or laboratory evidence for EMS.
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: J J
authors.initials: JJ
authors.lastname: Goronzy
authors.forename: C M
authors.initials: CM
authors.lastname: Weyand
mesh_terms: D000328:Adult; D002997:Clomipramine / Q000008:administration & dosage; D003866:Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D009468:Neuromuscular Diseases / Q000139:chemically induced*; D012008:Recurrence; D013577:Syndrome; D014364:Tryptophan / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D014364:Tryptophan; D002997:Clomipramine