The eosinophilia-myalgia syndrome is characterized by myalgia, fatigue, arthralgia, peripheral edema, rash and eosinophilia and is associated with ingestion of the amino acid L-tryptophan. The condition was first noted in 1989, and by July 1990, more than 1,000 cases had been reported. Sack and Criswell conducted a follow-up study to determine the longterm consequences of L-tryptophan-induced eosinophilia-myalgia syndrome.
The authors reviewed the medical records of 22 patients with eosinophiliamyalgia syndrome. The mean duration of follow-up was 22.5 months. Patients ranged from 30 to 75 years of age, with a mean age of 47 years, and all but one met the Centers for Disease Control and Prevention criteria for the syndrome. Twenty-one of the patients were women.
As shown in the table, more than 90 percent of the patients had persistent myalgia, fatigue, neuropathy and muscle cramps at follow-up. In addition, weakness, arthralgia, skin thickening, rashes and decreased joint motion persisted in a substantial percentage of patients. Half of the patients had respiratory symptoms; in two patients, these symptoms were significant. Laboratory abnormalities returned to normal during follow-up in most patients. However, serum aldolase levels remained slightly elevated in two patients, and peripheral eosinophil counts remained elevated in one patient.
Findings in Eosinophilia-Myalgia Syndwme
motion
From Sack KE, Criswell LA. Eosinophilia-myalgia syndrome: the aftermath. South Med J 1992;85:878- 82. Used with permission.
The authors conclude that for most patients, eosinophilia-myalgia syndrome is a chronic disorder. They were not able to link the long-term outcome of the syndrome to the various therapies used.
The authors also note that eosinophiliamyalgia syndrome has similarities to the toxic oil syndrome, a scleroderma-like illness associated with exposure to contaminated rapeseed oil. They believe that epidemics similar to eosinophilia-myalgia syndrome and toxic oil syndrome but with more devastating consequences may occur in the future. (Southern Medical journal, September 1992, vol. 85, p. 878.)
COPYRIGHT 1993 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group
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