Eosinophilia-myalgia syndrome. Results of national surveillance.
Eosinophilia-myalgia syndrome, a newly recognized disorder that occurred in epidemic proportions during 1989, is associated with ingestion of manufactured tryptophan. A case is defined by debilitating myalgias and absolute eosinophilia greater than or equal to 1.0 x 10(9) cells/L. As of July 10, 1990, a total of 1531 cases had been reported nationwide, including 27 deaths. The highest rates of reported illness are concentrated in the western states, 68% are non-Hispanic white women aged 35 years and older, and data on associated clinical findings suggest a multisystemic disorder. The most frequent features include arthralgia (73%), rash (60%), cough or dyspnea (59%), peripheral edema (59%), elevated aldolase level (46%), and elevations in the results of liver function tests (43%). Neuropathy or neuritis, resulting in paralysis and death in some patients, was seen in 27%, and chest roentgenogram abnormalities were noted in 21% of those tested. Ninety-one percent reported onset of symptoms during or after May 1989, and 97% reported having taken tryptophan before the onset of symptoms. Since the recall of over-the-counter preparations of tryptophan in November 1989, the number of new cases of this potentially fatal disorder has fallen dramatically.
Swygert
L A
LA
Division of Environmental Hazards and Health Effects, Centers for Disease Control, Atlanta, Ga.
Maes
E F
EF
Sewell
L E
LE
Miller
L
L
Falk
H
H
Kilbourne
E M
EM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004802:Eosinophilia / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles; D010146:Pain / Q000139:chemically induced / Q000453:epidemiology*; D011159:Population Surveillance; D012621:Seasons; D013577:Syndrome; D014364:Tryptophan / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
D014364:Tryptophan