An eosinophilia-myalgia syndrome related disorder associated with exposure to L-5-hydroxytryptophan.
OBJECTIVE
To determine whether L-5-hydroxytryptophan (L-5-HTP) associated with eosinophiliamyalgia syndrome (EMS) like illness contains impurities in a fashion similar to that described in L-tryptophan associated with EMS.


METHODS
Members of a family who became ill after exposure to L-5-HTP were evaluated at the National Institutes of Health. Data from patients with extended exposure to L-5-HTP were also examined. Samples of L-5-HTP were examined using high performance liquid chromatography.


RESULTS
One member of the family had EMS, and 2 others had eosinophilia. No patient in the other group reviewed developed the syndrome, although 2 patients developed eosinophilia. The L-5-HTP used by the family contained an impurity not present in samples from the other patient group. After replacement with L-5-HTP not containing this impurity, eosinophilia in 2 family members resolved.


CONCLUSIONS
Some L-5-HTP contains impurities that may be related to L-5-HTP associated EMS.
Michelson
D
D
Center for Food Safety and Applied Nutrition, Food and Drug Administration (FDA), Bethesda, MD.
Page
S W
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Casey
R
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Trucksess
M W
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Love
L A
LA
Milstien
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Wilson
C
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Massaquoi
S G
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Crofford
L J
LJ
Hallett
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D006916:5-Hydroxytryptophan / Q000009:adverse effects* / Q000737:chemistry; D000328:Adult; D002851:Chromatography, High Pressure Liquid; D004802:Eosinophilia / Q000139:chemically induced; D016603:Eosinophilia-Myalgia Syndrome / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male
D006916:5-Hydroxytryptophan