| Epidemiologic studies of the association of L-tryptophan with the eosinophilia-myalgia syndrome: a critique. | |
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MedLine Citation:
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PMID: 8895181 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In 1989 and 1990, 2 reports of a new disease labeled the eosinophilia-myalgia syndrome (EMS) and attributed to L-tryptophan (LT) were published. In subsequent studies a putative contaminant was implicated. In this review the following studies are considered: the initial 2 reports of the overall association, one report of an association between LT and eosinophilic fasciitis, and one report describing the scale of the apparent epidemic of LT induced EMS. Of the 2 initial studies, one included previously reported exposed cases, failed to rule out the possibility that early symptoms of EMS could have caused LT use rather than the reverse, and failed to adhere to the methods, as published. The 2nd study has not been published in a peer reviewed journal. The study of eosinophilic fasciitis was subject to information bias and misclassification of the timing of LT use. The apparent epidemic could have been an artefact of waxing and waning enthusiasm for reporting exposed cases to an EMS registry, corresponding with the timing and the amount of publicity given to the topic. The questionable validity of these studies considerably weakens the claim that LT or a contaminant caused EMS. |
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Authors:
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S Shapiro |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of rheumatology. Supplement Volume: 46 ISSN: 0380-0903 ISO Abbreviation: J Rheumatol Suppl Publication Date: 1996 Oct |
Date Detail:
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Created Date: 1997-03-07 Completed Date: 1997-03-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7806058 Medline TA: J Rheumatol Suppl Country: CANADA |
Other Details:
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Languages: eng Pagination: 44-58; discussion 58-9 Citation Subset: IM |
Affiliation:
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Slone Epidemiology Unit, Boston University School of Medicine, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Case-Control Studies Drug Contamination Eosinophilia / chemically induced Eosinophilia-Myalgia Syndrome / chemically induced* Epidemiologic Methods* Fasciitis / chemically induced Humans Tryptophan / adverse effects* |
| Chemical | |
Reg. No./Substance:
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73-22-3/Tryptophan |
| Comments/Corrections | |
Comment In:
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J Rheumatol Suppl. 1996 Oct;46:81-8; discussion 89-91
[PMID:
8895184
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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