Chronic immune activation in the eosinophilia-myalgia syndrome.
Eosinophilia-myalgia syndrome (EMS) is a multisystem illness of uncertain pathogenesis that occurred in an epidemic related to the ingestion of contaminated L-tryptophan. To investigate the role of immune dysfunction in EMS we prospectively measured a serologic index of T-cell activation, the soluble interleukin-2 receptor (sIL-2R), in 7 patients followed into the late stages of the illness. As a group, EMS patients had significantly elevated sIL-2R levels throughout the study. Five patients suffered chronic symptoms of myalgia, arthralgia, muscle cramps, fatigue, or subjective memory impairment and all had persistently elevated sIL-2R levels. Two patients had near-resolution of EMS and normal sIL-2R levels. We conclude that chronic symptoms are common in EMS and are associated with persistent T-cell activation as measured by serum sIL-2R levels. These findings suggest that immunosuppressive treatment may be beneficial in EMS.
McKinley
K L
KL
Department of Neurology, Baylor College of Medicine, Houston, Texas.
Harati
Y
Y
Schneider
L W
LW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016603:Eosinophilia-Myalgia Syndrome / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007107:Immune System / Q000503:physiopathology*; D008297:Male; D010951:Plasma Exchange; D011241:Prednisone / Q000627:therapeutic use; D015375:Receptors, Interleukin-2 / Q000378:metabolism; D012995:Solubility; D013997:Time Factors
D015375:Receptors, Interleukin-2; D011241:Prednisone