Document Detail

Eosinophilia-myalgia syndrome in patients ingesting a single source of L-tryptophan.
MedLine Citation:
PMID:  8474064     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To estimate the attack rate for eosinophilia-myalgia syndrome and to identify potential risk factors for illness among patients attending a New York City medical clinic, who purchased L-tryptophan containing products produced exclusively by Showa Denko K.K. METHODS: A case-control design was used. Cases and controls purchased L-tryptophan containing products at the medical clinic from July 1, 1989--December 1, 1989. All case-patients identified with illness onset during the study period were included. Controls were selected by a systematic sample of the 683 purchasers of L-tryptophan attending the same clinic. RESULTS: Twelve (2.2%) of an estimated 553 L-tryptophan users were case-patients. Multivariate analysis suggested that lot 2 use (adjusted odds ratio [OR] = 35.9), concomitant use of chromium (adjusted OR = 12.3), and concomitant use of pyridoxine (adjusted OR = 5.8) were associated with the development of illness. Chemical analysis of tablets corresponding to the 3 Showa Denko K.K. lots ingested by study participants showed that lot 2 had the highest concentration of ethylidenebis (L-tryptophan), a proposed causative agent or marker for a causative agent in the eosinophilia-myalgia syndrome. CONCLUSIONS: Information from our study of persons exposed to implicated L-tryptophan supports the role for a contaminant as the causative agent in the eosinophilia-myalgia syndrome and identifies possible cofactors that deserve further study.
K J Henning; E Jean-Baptiste; T Singh; R H Hill; S M Friedman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  20     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  1993 Feb 
Date Detail:
Created Date:  1993-05-18     Completed Date:  1993-05-18     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  273-8     Citation Subset:  IM    
Division of Field Epidemiology, Centers for Disease Control, Atlanta, GA.
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MeSH Terms
Case-Control Studies
Chromium / adverse effects
Dose-Response Relationship, Drug
Drug Interactions
Eosinophilia-Myalgia Syndrome / chemically induced*,  epidemiology
Middle Aged
Multivariate Analysis
New York City / epidemiology
Pyridoxine / adverse effects
Risk Factors
Tryptophan / adverse effects*
Reg. No./Substance:
65-23-6/Pyridoxine; 73-22-3/Tryptophan; 7440-47-3/Chromium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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