Open AccessPost‐epidemic eosinophilia–myalgia syndrome associated with L‐tryptophan
Author(s) -
Allen Jeffrey A.,
Peterson Alicia,
Sufit Robert,
Hinchcliff Monique E.,
Mahoney J. Matthew,
Wood Tammara A.,
Miller Frederick W.,
Whitfield Michael L.,
Varga John
Publication year - 2011
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.30514
Subject(s) - eosinophilia , myalgia , medicine , incidence (geometry) , tryptophan , dermatology , immunology , gastroenterology , biology , biochemistry , physics , amino acid , optics
Eosinophilia–myalgia syndrome (EMS) is characterized by subacute onset of myalgias and peripheral eosinophilia, followed by chronic neuropathy and skin induration. An epidemic of EMS in 1989 was linked to consumption of L‐tryptophan that had originated from a single source. Following the ban by the Food and Drug Administration (FDA) on the sale of L‐tryptophan, the incidence of EMS declined rapidly. Moreover, no new cases have been described since the FDA ban was lifted in 2005. We report the clinical, histopathologic, and immunogenetic features of a new case of L‐tryptophan–associated EMS, along with evidence of activated transforming growth factor β and interleukin‐4 signaling in the lesional skin.