title: [Acute respiratory failure as a manifestation of eosinophilia-myalgia syndrome associated with L-tryptophan intake].
abstract: Eosinophilia-myalgia syndrome was described in 1989 in patients who presented progressive and incapacitating myalgia and eosinophilia in blood, fluids and secretions. Most patients report previous L-tryptophan intake. Respiratory manifestations are found in up to 80% of the cases, occasionally as the only manifestation. Treatment includes drug discontinuation and administration of corticosteroids. Here, we describe the case of a 61-year-old female admitted with acute respiratory failure after using L-tryptophan, hydroxytryptophan and other drugs. The patient presented eosinophilia, together with elevated eosinophil counts in the bronchoalveolar lavage and pleural effusion. After discontinuation of the drugs previously used, corticosteroids were administered, resulting in clinical and radiological improvement within just a few days.
authors.affiliation: Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil. tiagoguerra@mpc.com.br
authors.forename: Tiago de Araujo Guerra
authors.initials: Tde A
authors.lastname: Grangeia
authors.forename: Marcelo
authors.initials: M
authors.lastname: Schweller
authors.forename: Ilma Aparecida
authors.initials: IA
authors.lastname: Paschoal
authors.forename: Lair
authors.initials: L
authors.lastname: Zambon
authors.forename: Mônica Corso
authors.initials: MC
authors.lastname: Pereira
mesh_terms: D000208:Acute Disease; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D016603:Eosinophilia-Myalgia Syndrome / Q000139:chemically induced* / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D011859:Radiography; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014364:Tryptophan / Q000009:adverse effects*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005938:Glucocorticoids; D014364:Tryptophan; D011239:Prednisolone