[The tryptophan-associated eosinophilia-myalgia syndrome. A clinical follow-up of 8 patients].
Seven women and one man aged from 51 to 70 years suffered from eosinophilia-myalgia syndrome after taking medicines containing tryptophan for depression or sleep disorders; the total duration of intake ranged from three to 106 months and the average daily dose was 1312 mg. All the patients had muscle pains and skin lesions resembling scleroderma together with impairment of general well being; six of them had high eosinophil counts of up to 2,600 cells/microliters (mean 1,629); other symptoms were weight loss, pruritus, fever, dyspnoea and sensory abnormalities. Discontinuation of tryptophan combined with systemic treatment with prednisone in doses of 32 or 20 mg/d for 4 to 16 weeks soon brought the eosinophil counts down, but the skin lesions, muscle pains and other symptoms showed little improvement over a follow-up period averaging 17.1 months. Treatment with penicillin G (20 mega-units daily for 14 days), azathioprine (100 mg daily for 2 months) or cyclosporin (2.5 mg/kg.day) was tried in some cases but had no significant effect.
Szeimies
R M
RM
Klinik und Poliklinik für Dermatologie, Universität München.
Meurer
M
M
D000368:Aged; D001706:Biopsy; D004359:Drug Therapy, Combination; D016603:Eosinophilia-Myalgia Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000473:pathology; D009230:Myxedema / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012595:Scleroderma, Systemic / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012867:Skin / Q000473:pathology; D014364:Tryptophan / Q000009:adverse effects*
D014364:Tryptophan