eosinophilia myalgia syndrome
Summary: A complex systemic syndrome with inflammatory and autoimmune components that affect the skin, fascia, muscle, nerve, blood vessels, lung, and heart. Diagnostic features generally include EOSINOPHILIA, myalgia severe enough to limit usual activities of daily living, and the absence of coexisting infectious, autoimmune or other conditions that may induce eosinophilia. Biopsy of affected tissue reveals a microangiopathy associated with diffuse inflammation involving connective tissue. (From Spitzer et al., J Rheumatol Suppl 1996 Oct;46:73-9; Blackburn WD, Semin Arthritis Rheum 1997 Jun;26(6):788-93)
- Scleroderma-like cutaneous syndromesYasuji Mori
Section of Rheumatology, University of Illinois at Chicago College of Medicine, 1158 MBRB, 900 S Ashland Avenue, Chicago, IL 60607 7171, USA
Curr Rheumatol Rep 4:113-22. 2002..In addition, there is no consensus on optimal management. Much anecdotal information and small clinical series indicate that phototherapy may have a role in the treatment of scleroderma-like conditions...
- Safety of 5-hydroxy-L-tryptophanYesu T Das
ISSI Laboratories Inc, 515 Blue Ridge Avenue, Piscataway, NJ 08854, USA
Toxicol Lett 150:111-22. 2004..A minor chromatographic peak (peak X) reported in some 5-HTP samples lacks credibility due to chromatographic artifacts and infinitesimal concentrations, and has raised undue speculations concerning its chemistry and toxicity...
- Is there any relationship between eosinophilia myalgia syndrome (EMS) and fibromyalgia syndrome (FMS)? An analysis of clinical and immunological dataH Barth
Department of Internal Medicine, University of Tubingen, Germany
Adv Exp Med Biol 467:487-96. 1999..We, therefore, conclude that EMS may have developed in patients suffering primarily from FMS as an allergic reaction towards a more immunogenic L-tryptophan preparation...
- Enhanced collagen synthesis and transcription by peak E, a contaminant of L-tryptophan preparations associated with the eosinophilia myalgia syndrome epidemicH Takagi
University of Miami School of Medicine, Department of Dermatology and Cutaneous Surgery, Florida 33136, USA
J Clin Invest 96:2120-5. 1995The pathogenesis of the eosinophilia myalgia syndrome (EMS) remains unclear...
- Rapid HPLC screening method for contaminants found in implicated L-tryptophan associated with eosinophilia myalgia syndrome and adulterated rapeseed oil associated with toxic oil syndromeB L Williamson
Department of Biochemistry and Molecular Biology, Mayo Clinic Foundation, Rochester, MN 55905, USA
Biomed Chromatogr 12:255-61. 1998..Eight years later a closely related disease, the eosinophilia myalgia syndrome (EMS), was reported in the USA with many additional cases being reported worldwide...
- Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 35-2004. A 68-year-old man with end-stage renal disease and thickening of the skinSamuel L Moschella
Department of Dermatology, Lahey Clinic, Burlington, Mass, USA
N Engl J Med 351:2219-27. 2004
- A heretofore undisclosed crux of eosinophilia-myalgia syndrome: compromised histamine degradationM J Smith
Division of Natural Products, Center for Food Safety and Applied Nutrition, Food and Drug Administration, 5100 Paint Branch Parkway, College Park, Maryland 20740 3835, USA
Inflamm Res 54:435-50. 2005..A final common pathway for syndromes characterized by eosinophilia with myalgia is now evident...
- [Diagnostic problems in eosinophilic fasciitis]Mariusz Puszczewicz
Pol Arch Med Wewn 116:777-80. 2006..The difficulties in differentition of the symptoms between eosinophilic fasciitis and "eosinophilia-myalgia syndrome" are discussed...
- Drug-induced eosinophilic lung diseaseJames N Allen
Division of Pulmonary and Critical Care Medicine, The Ohio State University, 201 Heart Lung Institute Building, 473 West 12th Avenue, Columbus, OH 43210, USA
Clin Chest Med 25:77-88. 2004..In all patients, the diagnosis requires exclusion of other causes of eosinophilic lung disease by history, and, if necessary, laboratory testing or lung biopsy...
- Structural characterization of a case-implicated contaminant, "Peak X," in commercial preparations of 5-hydroxytryptophanKlaus Klarskov
Biomedical Mass Spectrometry and Functional Proteomics Facility, Mayo Clinic, Rochester, Minnesota, USA
J Rheumatol 30:89-95. 2003OBJECTIVE: To determine the chemical structure of a contaminant, X1, previously found in eosinophilia myalgia syndrome case-implicated 5-hydroxytryptophan (5-OHTrp), and also present in over-the-counter (OTC) commercially available 5-..
- Calcinosis cutis in a patient with eosinophilia-myalgia syndrome: case reportElizabeth Smith
Department of Dermatology, Mount Sinai Medical Center, One Gustave L Levy Place, New York, NY 10029, USA
Cutis 77:361-4. 2006..If more patients with EMS develop calcinosis cutis, it will present a therapeutic challenge to the physicians managing these patients...
- [Acute respiratory failure as a manifestation of eosinophilia-myalgia syndrome associated with L-tryptophan intake]Tiago de Araujo Guerra Grangeia
Departamento de Clinica Medica, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
J Bras Pneumol 33:747-51. 2007..After discontinuation of the drugs previously used, corticosteroids were administered, resulting in clinical and radiological improvement within just a few days...
- Generation of quinoneimine intermediates in the bioactivation of 3-(N-phenylamino)alanine (PAA) by human liver microsomes: a potential link between eosinophilia-myalgia syndrome and toxic oil syndromeAnna Martínez Cabot
Department of Biological Organic Chemistry, Institut d Investigacions Quimiques i Ambientals de Barcelona, Spain
Chem Res Toxicol 20:1556-62. 2007..These findings establish that EMS and TOS are linked by a common toxic metabolite (4-aminophenol) and that they may be further linked by the concomitant release of potentially hazardous carbonyl species...
- Part II. Eosinophilia-Myalgia Syndrome: further correlations between compromised histamine degradation, eosinophilias and myopathiesM J Smith
Division of Natural Products, Center for Food Safety and Applied Nutrition, Food and Drug Administration, 5100 Paint Branch Parkway, College Park, Maryland 20740-3835, USA
Inflamm Res 56:S7-8. 2007
- Toxic oil syndrome: survival in the whole cohort between 1981 and 1995P Sánchez-Porro Valadés
Centro de Investigación sobre el Síndrome del Aceite Tóxico y Enfermedades Raras, Instituto de Salud Carlos III, C Sinesio Delgado, 6 28029 Madrid, Spain
J Clin Epidemiol 56:701-8. 2003..Previous studies have addressed mortality only by gender and age. We analyzed possible prognostic factors in the survival of the cohort...
- Strain-dependent acute lung injury after intra-tracheal administration of a 'refined' aniline-denatured rapeseed oil: a murine model of the toxic oil syndrome?Hadewijch M Vanhooren
Laboratory of Lung Toxicology, K U Leuven, Leuven, Belgium
Food Chem Toxicol 45:2563-73. 2007..The observation of strain-dependent effects suggests that genetic susceptibility is an important factor in disease induction by the RSO160401 oil...
- Pulmonary hypertension as a result of drug therapyTim Higenbottam
Division of Clinical Science South, Medical School, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2RX, UK
Clin Chest Med 25:123-31. 2004..Life and medicine are a continuing challenge as our exploration of the regions of unknown biology throw up new targets and new mechanisms and may catch us again as the anorectic (anorectic) drug caught our predecessors...
- [Current differential diagnosis of hypereosinophilic syndrome]Vera Dinić Uzurov
Klinika za hematologiju, Klinicki centar Vojvodine, Novi Sad
Med Pregl 60:581-6. 2007..Hypereosinophilic syndrome is a subcategory of idiopathic eosinophilia. If the differential diagnosis of hypereosinophilia fails to resolve the etiology succesfully, the diagnosis of idiopathic HES remains...
- Oxidative damage in rat tissue following excessive L-tryptophan and atherogenic dietsN Ronen
Division of Morphological Sciences, Anatomy and Cell Biology, Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
Adv Exp Med Biol 467:497-505. 1999..published on the connection between diets containing excessive L-tryptophan and the development of Eosinophilia Myalgia Syndrome. It has been also demonstrated that some cell functions depend on fatty acid composition which can ..
- [Skin manifestations of toxic syndrome due to denatured rapeseed oil]E Fonseca
Servicio de Dermatologia, Complejo Hospitalario Universitario de A Coruña, Espana
Actas Dermosifiliogr 100:857-60. 2009..This syndrome resembled toxic oil syndrome in many ways and demonstrated that mucinosis and toxic sclerodermatous processes do exist...
- Tetrahydro-beta-carboline-3-carboxylic acids and contaminants of L-tryptophanJ Adachi
Department of Legal Medicine, Kobe University School of Medicine, Japan
J Chromatogr A 881:501-15. 2000..Ethanol and/or acetaldehyde-induced formation of MTCA, as well as tryptophan-induced formation of TCCA, occurred endogenously in man and animals...
- Is the L-tryptophan metabolite quinolinic acid responsible for eosinophilic fasciitis?R Noakes
Qld Skin and Cancer Foundation, Greenslopes Private Hospital, Newdegate St, Greenslopes 4120, QLD, Australia
Clin Exp Med 6:60-4. 2006..The interleukin-5 stain was negative. Our results suggest that quinolinic acid may play a role in cutaneous eosinophilic disorders...
- Miliary tuberculosis in a patient with eosinophilic fasciitisBernardino Roca
Department of Medicine, Divisions of Infectious Disease and Dermatology, General Hospital of Castellon, Castellon, Spain
South Med J 98:107-10. 2005..Other conditions, especially neoplasms and infections, have been described in association with eosinophilic fasciitis, but this is the first reported case of miliary tuberculosis associated with the disease...
- Neuromuscular disorders associated with apical hypertrophic cardiomyopathyJosef Finsterer
Krankenanstalt Rudolfstiftung, Vienna, Austria
Acta Cardiol 64:85-9. 2009..Cardiomyopathy is a frequent manifestation of neuromuscular disorders...
- Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophanErick H Turner
Mood Disorders Center, Portland VA Medical Center, Portland, OR 97239, USA
Pharmacol Ther 109:325-38. 2006..Safety issues with 5-HTP are also reviewed, with emphasis on eosinophilia myalgia syndrome (EMS) and serotonin syndrome.
- The hypothalamic-pituitary-adrenal axis in autoimmunityM S Harbuz
Department of Hospital Medicine, Bristol Royal Infirmary, United Kingdom
Ann N Y Acad Sci 823:214-24. 1997..a number of other immune-mediated disease models, including experimental allergic encephalomyelitis, eosinophilia myalgia syndrome, systemic lupus erythematosus, and leishmaniasis...
- Absent neutrophil alkaline phosphatase in the eosinophilia myalgia syndrome associated with L-tryptophan useJ P Jaffe
Department of Internal Medicine, St Paul Ramsey Medical Center, Minnesota 55101
Am J Hematol 36:280-1. 1991..basophilia, and absent stainable NAP, initially suggesting the diagnosis of CML in a patient with the eosinophilia myalgia syndrome associated with L-tryptophan use, a condition resembling eosinophilic fasciitis...
- The eosinophilia-myalgia syndrome: the Los Alamos ConferenceP A Hertzman
Los Alamos Medical Center, NM 87544
J Rheumatol 18:867-73. 1991..Fifty presentations covered a variety of important issues which are summarized herein...
- Drug-, toxin-, and radiation therapy-induced eosinophilic pneumoniaJoshua Solomon
Department of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA
Semin Respir Crit Care Med 27:192-7. 2006..Radiation therapy has also been associated with the development of eosinophilic pneumonia in patients receiving this treatment for breast cancer...
- Structural characterization of contaminants in commercial preparations of melatonin by on-line HPLC-electrospray ionization-tandem mass spectrometryS Naylor
Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN 55905, USA
Adv Exp Med Biol 467:769-77. 1999..These latter contaminants are structural analogues of the case-associated peak "E" found in L-tryptophan implicated in onset of eosinophilia-myalgia syndrome. The significance of these findings is discussed...
- Non-L-tryptophan related eosinophilia-myalgia syndrome with hypoproteinemia and hypoalbuminemiaLeon Margolin
Department of Medicine, Rabin Medical Center, Petah Tiqva, Israel
J Rheumatol 30:628-9. 2003
- Possible lansoprazole-induced eosinophilic syndromeJ D Smith
Department of Pharmacy Practice, University of Florida, Gainesville, USA
Ann Pharmacother 32:196-200. 1998..CONCLUSIONS: It is important to consider medications when diagnosing patients with hypereosinophilia and/or myalgia...
- [Shulman's syndrome (eosinophilic fasciitis)]S Akanay-Diesel
Hautklinik, Universitatsklinikum Dusseldorf, Moorenstr 5, 40225 Dusseldorf
Hautarzt 60:278-81. 2009..The gold standard for diagnosis is--as was done in our case--a deep skin-to-muscle biopsy. Further imaging, especially magnetic resonance imaging, can support the diagnostic procedure...
- Neurologic, MR imaging, and MR spectroscopic findings in eosinophilia myalgia syndromeL J Haseler
Center for Non Invasive Diagnosis, University of New Mexico Health Sciences Center, Albuquerque, USA
AJNR Am J Neuroradiol 19:1687-94. 1998BACKGROUND AND PURPOSE: Eosinophilia myalgia syndrome (EMS), a multisystemic disease induced by exposure to L-tryptophan, may result in serious CNS abnormalities...
- On-line HPLC-tandem mass spectrometry structural characterization of case-associated contaminants of L-tryptophan implicated with the onset of eosinophilia myalgia syndromeB L Williamson
Biomedical Mass Spectrometry Facility and Department of Biochemistry and Molecular Biology, Mayo Clinic Mayo Foundation, Rochester, MN 55905, USA
Toxicol Lett 99:139-50. 1998..This is significant since a case-associated contaminant found in 5-hydroxy-Trp also contains an indoline ring, and the chemical reactivity of this ring system may possibly play a role in the etiology of EMS...
- Scleroderma-like disordersR Foti
Rheumatology Unit, Azienda Ospedaliera Universitaria V Emanuele, Ferrarotto, S Bambino Catania, Italy
Autoimmun Rev 7:331-9. 2008..Some of them are associated with autoantibodies and/or autoimmune conditions. An accurate recognition of these scleroderma-like diseases is important for the institution of the most appropriate treatment...
- Synthesis and formation of an EMS correlated contaminant in biotechnologically manufactured L-tryptophanB Muller
Institute for Biochemistry and Food Chemistry, University of Hamburg
Adv Exp Med Biol 467:481-6. 1999..IMT formation was observed at acidic and alkaline pH-values and the optimal molar ratio of Trp to IM is 100:1. In addition an IMT formation was observed from indole, formaldehyde and Trp as well as from Trp and 3-indolylacetaldehyde...
- Activity of certain drugs in inducing of inflammatory myopathies with cutaneous manifestationsLyubomir A Dourmishev
University of Medicine, Department of Dermatology and Venereology, 1 St Georgi Sofiiski Street, 1431 Sofia, Bulgaria
Expert Opin Drug Saf 7:421-33. 2008..At present, the pharmacological activity of drugs in inducing of inflammatory myopathies is not a solved problem...
- Demonstration of interleukin 8 and autoantibodies to interleukin 8 in the serum of patients with systemic sclerosis and related disordersS Reitamo
Department of Dermatology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107
Arch Dermatol 129:189-93. 1993..This activation could be related to the production of autoantibodies to IL-8...
- Tryptophan toxicity--time and dose response in ratsB Gross
Department of Neurology, Carmel Medical Center, Faculty of Medicine, Haifa, Israel
Adv Exp Med Biol 467:507-16. 1999..past decade L-tryptophan (Trp) ingestion have been associated with a multisystemic syndrome, known as eosinophilia myalgia syndrome (EMS)...
- [Diagnostic performance of echocardiography in the follow-up of patients with toxic oil syndrome]María M Plaza Cano
Centro de Investigación Clínica para el Síndrome del Aceite Tóxico y Enfermedades Raras CISATER Hospital Carlos III Instituto de Salud Carlos III Madrid Spain
Rev Esp Cardiol 56:1195-201. 2003..We conducted a study to assess the validity of our indications for echocardiography in the follow-up of cardiovascular disorders in patients with this disease...
- L-tryptophan-induced eosinophilia-myalgia syndrome. II. Partial correction of abnormal tryptophan metabolism by pyridoxineC Mainetti
Department of Dermatology, , Geneva, Switzerland
Dermatologica 183:62-5. 1991..This study (i) confirms that an abnormal metabolism of L-tryptophan occurs in EMS patients and (ii) shows that this can be corrected by pyridoxine...
- Rigorous new approach to constructing a gold standard for validating new diagnostic criteria, as exemplified by the eosinophilia-myalgia syndromeP A Hertzman
Los Alamos Medical Center, Suite 130, West Road, Los Alamos, NM 87544, USA
Arch Intern Med 161:2301-6. 2001..The goal, for research classifications, was to construct validated clinically sensible criteria and to develop improved methods that can be used for other disorders...
- Eosinophilic perimyositis as the presenting feature of a monoclonal T-cell expansionMurielle Dunand
Neurology Service, CHU Vaudois, Room BH07 306, 1011 Lausanne, Switzerland
Muscle Nerve 31:646-51. 2005..Although the pathogenesis behind the T-cell expansion is unclear but probably inflammatory, we suggest regular follow-up to allow early treatment of any T-cell lymphoproliferative malignancy that may develop...
- [Eosinophilic myositis in a 9 year old boy]J L Pena Segura
Servicio de Pediatría Hospital General Universitario de Guadalajara, Guadalajara, 19002, Espana
Rev Neurol 33:960-3. 2001..The eosinophilic myopathies should be distinguished from the commoner inflammatory myopathies such as polymyositis and dermatomyositis...
- PanniculitisMaryanna C Ter Poorten
Department of Dermatology, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 623, PO Box 250618, Charleston, SC 29425, USA
Dermatol Clin 20:421-33, vi. 2002....
- Autoimmune diseases associated with drugs, chemicals and environmental factorsD D'Cruz
The Bone and Joint Research Unit, St Bartholomew s and the Royal London School of Medicine and Dentistry, Charterhouse Square, London, UK
Toxicol Lett 112:421-32. 2000..A number of autoimmune connective tissue diseases may therefore be associated with exposure to drugs, chemicals and environmental factors and the risks associated with these should be minimised where possible...
- Eosinophilia-myalgia syndrome: selective cognitive impairment, longitudinal effects, and neuroimaging findingsC Armstrong
Department of Neurology, University of Pennsylvania Medical School, Philadelphia, USA
J Neurol Neurosurg Psychiatry 63:633-41. 1997..Abnormalities of white matter appeared in the MRI of eight of 12 patients. CONCLUSIONS: The neurocognitive and neuroimaging findings contribute to the evidence which indicates that the neural substrate of EMS is white matter damage...
- Autoantibodies to nuclear lamin C in the eosinophilia-myalgia syndrome associated with L-tryptophan ingestionJ Varga
Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107
Arthritis Rheum 35:106-9. 1992..The occurrence of anti-lamin C autoantibodies in one EMS patient expands the spectrum of clinical conditions associated with these antibodies, and provides evidence for an autoimmune response in EMS...
- Tryptophan toxicity: a pharmacoepidemiologic review of eosinophilia-myalgia syndromeD S Milburn
School of Pharmacy, University of Pittsburgh, PA 15261
DICP 25:1259-62. 1991..Efforts are currently underway to confirm the structure of the contaminant by laboratory synthesis and to define its biologic and toxic effects using an animal model for EMS...
- L-tryptophan-induced eosinophilia-myalgia syndrome. I. Report of two cases with pseudoxanthoma-elasticum-like skin changesC Mainetti
Department of Dermatology, , Geneva, Switzerland
Dermatologica 183:57-61. 1991..Histology was compatible with the diagnosis; electron microscopy did not reveal calcium deposits. PXE-like changes may represent an additional feature of the pleomorphic L-tryptophan-induced EMS...
- Central and peripheral nervous system involvement in the L-tryptophan associated eosinophilia myalgia syndromeL M Tolander
Department of Neurology, University of Arizona, Tucson 85724
Int J Neurosci 61:69-75. 1991..The various effects of eosinophilia on the nervous system are reviewed. The persistence of the neurological complications despite resolution of eosinophilia and steroid therapy is emphasized...
- Eosinophilia caused by administration of L-tryptophan to animals with adrenal dysfunctionT Shishikura
Life Science Research Laboratory, Showa Denko K K, Tokyo, Japan
Toxicol Lett 58:315-21. 1991..The results suggest that EMS may have been caused, not by L-tryptophan alone, but by the combined effects of adrenal dysfunction and L-tryptophan ingestion...
- Corticosteroid-induced juxta-articular adiposis dolorosaS S Greenbaum
Department of Dermatology, Jefferson Medical College, Philadelphia, PA 19107
Arch Dermatol 127:231-3. 1991..Alterations of fat metabolism induced by corticosteroid excess may have played a role in the development of this unusual painful syndrome...
- Eosinophilic fasciitis is clinically distinguishable from the eosinophilia-myalgia syndrome and is not associated with L-tryptophan useJ Varga
Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107
J Rheumatol 18:259-63. 1991..In contrast to eosinophilia-myalgia syndrome, EF is not associated with L-tryptophan ingestion...
- Peripheral neuropathy associated with eosinophilia-myalgia syndromeT D Heiman-Patterson
Department of Neurology, Jefferson Medical College, Philadelphia, PA 19107 5083
Ann Neurol 28:522-8. 1990..The cause of the neuropathy is unknown but may include immune mechanisms or toxicity of eosinophils, L-tryptophan, its metabolic products, or contaminants within L-tryptophan preparations...
- Continuing occurrence of eosinophilia myalgia syndrome in CanadaW O Spitzer
Potsdam Institute of Pharmacoepidemiology and Technology Assessment, Germany
Br J Rheumatol 34:246-51. 1995b>Eosinophilia myalgia syndrome (EMS), was defined by the Centers for Disease Control (CDC) as eosinophilia > 1000 mm3 and incapacitating myalgia without infection or neoplasm...
- Drug-related lupusE V Hess
University of Cincinnati Medical Sciences Center, Ohio
Curr Opin Rheumatol 3:809-14. 1991..Continued study of this human experimental model of lupus will help to clarify the etiology and mechanisms of systemic lupus erythematosus itself...
- [Polyneuropathy and fasciitis in eosinophilia-myalgia syndrome]W Hetzel
Fortschr Neurol Psychiatr 59:425-31. 1991..In contrast with the majority of published cases, which showed predominance of axonal damage, our patient displayed the clinical and electro-physiologic characteristics of demyelinating neuropathy...
- Demyelinating polyneuropathy in eosinophilia-myalgia syndromeP D Donofrio
Department of Neurology, Bowman Gray School of Medicine, Wake Forest University, Winston Salem, North Carolina 27157 1078
Muscle Nerve 15:796-805. 1992..In addition to other organ involvement, EMS may manifest as a potentially fatal polyneuropathy, which initially appears to have prominent demyelinating features...
- Cutaneous manifestations of the eosinophilia-myalgia syndromeJ R Oursler
Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
Br J Dermatol 127:138-46. 1992..Mean follow-up of 24 months after discontinuation of L-tryptophan revealed the presence of persistent severe disabling disease in 30% of patients...
- L-tryptophan syndrome: histologic features of scleroderma-like skin changesS B Guerin
Denver General Hospital, Colorado 80204
J Cutan Pathol 19:207-11. 1992..Skin biopsies showed increased dermal mucin and dermal sclerosis, with trapping of adnexal structures. There are clinical and histologic similarities between EMS, scleroderma, the toxic oil syndrome, and fasciitis with eosinophils...
- Tryptophan metabolism via the kynurenine pathway in patients with the eosinophilia-myalgia syndromeR M Silver
Department of Medicine, Medical University of South Carolina, Charleston 29425
Arthritis Rheum 35:1097-105. 1992..5 gm) resulted in high concentrations of kynurenine-pathway metabolites in blood and extrahepatic tissues, which was accentuated in EMS patients and which may have played a significant role in the pathogenesis of the disease...
- The toxic oil syndrome (TOS, 1981): from the disease towards a toxicological understanding of its chemical aetiology and mechanismW N Aldridge
Robens Institute of Health and Safety, University of Surrey, Guildford, UK
Toxicol Lett 64:59-70. 1992..There is no experimental animal model. A new disease, Eosinophilia Myalgia Syndrome (EMS) which appeared late in 1989 in the USA, is due to the consumption of impure 1-tryptophan...
- Alterations in tryptophan metabolism in the toxic oil syndrome and in the eosinophilia-myalgia syndromeR M Silver
Department of Medicine, Medical University of South Carolina, Charleston 29425
J Rheumatol 19:69-73. 1992....
- L-tryptophan-associated eosinophilic fasciitis prior to the 1989 eosinophilia-myalgia syndrome outbreakJ R Hibbs
NHLBI CHB, National Institutes of Health, Bethesda, MD 20892
Arthritis Rheum 35:299-303. 1992..CONCLUSION. LT ingestion was associated with EF prior to the 1989 outbreak of eosinophilia-myalgia syndrome. Lung abnormalities may be a distinguishing feature of LT-mediated illness...
- Eosinophilia-myalgia syndrome not associated with L-tryptophanM A Patmas
Community Medical Center, Toms River, NJ
N J Med 89:285-6. 1992..The author reports a case of eosinophilia-myalgia syndrome (EMS), not associated with the use of tryptophan. Other nutritional supplements should be considered as possible etiologic agents in EMS. Further research in this area is needed...
- Eosinophilic hepatitis: a new feature of the clinical spectrum of the eosinophilia-myalgia syndromeP Martinez Osuna
Department of Medicine, Louisiana State University School of Medicine, New Orleans
Clin Rheumatol 13:528-32. 1994..The occurrence of clinically overt hepatic involvement has not been reported previously. Potential mechanisms of liver damage in eosinophilia-myalgia syndromes are discussed...
- New cutaneous manifestations of systemic diseasesS D Khorenian
Mount Sinai Medical Center, New York, New York
Am Fam Physician 51:625-30. 1995..Paraneoplastic pemphigus, a recently characterized autoimmune vesicular eruption, produces painful mucocutaneous ulcerations in patients with an occult neoplasm, such as chronic lymphocytic leukemia or malignant lymphoma...
- Comparative studies on tryptophan binding to hepatic nuclear envelopes in Sprague-Dawley and Lewis ratsH Sidransky
Department of Pathology, George Washington University Medical Center, Washington, District of Columbia 20037
Am J Physiol 267:R502-7. 1994..The possible significance of the quantitative difference in the binding affinity of L-tryptophan to hepatic nuclei of Lewis rats compared with those of Sprague-Dawley rats is as yet undetermined...
- Analytical characterization of peptide contaminants of L-tryptophanE R Barnhart
Centers for Disease Control and Prevention CDC, National Center for Environmental Health, Atlanta, Georgia 30341 3724, USA
Arch Environ Contam Toxicol 30:142-8. 1996..In order to determine whether a correlation exists between individual EMS cases and the concentration of peptides or bacitracin consumed, reliable methods must be developed for quantification of the total of isoforms...
- 1,1'-Ethylidenebis[L-tryptophan], an impurity in L-tryptophan associated with eosinophilia-myalgia syndrome, stimulates type I collagen gene expression in human fibroblasts in vitroJ G Zangrilli
Division of Pulmonary Critical Care, Jefferson Medical College, Philadelphia, PA, USA
Biochem Mol Biol Int 37:925-33. 1995..In contrast, expression mRNA for fibronectin was not affected. These findings indicate that EBT stimulates type I collagen production by human fibroblast, and suggest that EBT may be involved in the development of fibrosis in EMS...
- Eosinophilic fasciitis: report of a case diagnosed 14 years after its onsetB Ferlazzo
Istituto di Patologia Medica, , Messina
Minerva Med 86:495-8. 1995..Failure to carry out an adeguate histopathological examination during this period played a role in delaying diagnosis...
- Eosinophilia-myalgia syndrome among the non-L-tryptophan users and pre-epidemic casesE A Sullivan
Division of Environmental Hazards and Health Effects, Centers for Disease Control and Prevention, U S Department of Health and Human Services, Atlanta, USA
J Rheumatol 23:1784-7. 1996..Pre-epidemic EMS cases were more likely to report the presence of neuropathy and scleroderma-like skin change, but not pulmonary symptoms, hospitalization, or death...
- Fibromyalgia, psychiatric disorders, and assessment of the longterm outcome of eosinophilia-myalgia syndromeJ I Hudson
Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA 02178, USA
J Rheumatol Suppl 46:37-42; discussion 42-3. 1996..These observations have implications for the clinical management of patients with a history of EMS and for interpretation of studies of the longterm outcome of EMS...
- Bias or biology: evaluating the epidemiologic studies of L-tryptophan and the eosinophilia-myalgia syndromeR I Horwitz
Department of Medicine and Epidemiology, Yale University School of Medicine, New Haven, Connecticut 06520 8056, USA
J Rheumatol Suppl 46:60-72. 1996..In light of these analyses, it appears that the cause of EMS has not been definitively identified. The search for the cause of EMS should continue without the underlying assumption that LT or some contaminant is responsible...
- Animal models of the eosinophilia-myalgia syndromeD J Clauw
Division of Rheumatology, Immunology, and Allergy, Georgetown University Medical Center, Washington, DC 20007, USA
J Rheumatol Suppl 46:93-7; discussion 92, 97-8. 1996..The precise cause of EMS remains unknown...
- Effect of L-tryptophan products on function of human eosinophils: investigation of the causal mechanisms of eosinophilia myalgia syndrome associated with L-tryptophan productsH Saito
Clinical Research Center for Rheumato Allergology, National Sagamihara Hospital, Kanagawa, Japan
Int Arch Allergy Immunol 111:37-42. 1996..These findings suggest that contaminants in the L-tryptophan products modify the several functions of eosinophils and play a role in the pathogenesis of eosinophil myalgia syndrome...
- Epidemiology of potential association between L-tryptophan ingestion and eosinophilia-myalgia syndromeS R Daniels
Department of Pediatrics, University of Cincinnati College of Medicine, Ohio, USA
J Clin Epidemiol 48:1413-27; discussion 1429-40. 1995..Subsequent studies of brand of L-tryptophan also contained errors in design, which may have produced biased results and call the conclusions into question. The cause of eosinophilia-myalgia syndrome remains unknown...
- Long-term follow-up of patients with diffuse fasciitis and eosinophilia associated with L-tryptophan ingestionE Beko
Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Florida
Cutis 51:266-70. 1993..Both patients fit the Centers for Disease Control's criteria for eosinophilia-myalgia syndrome. The literature on the eosinophilia-myalgia syndrome is reviewed...
- Axonal neuropathy in eosinophilia-myalgia syndromeS M Burns
Department of Neurology, Columbia Presbyterian Medical Center, New York, New York
Muscle Nerve 17:293-8. 1994..Sural nerve biopsy in one case showed epineural perivascular inflammation. Our data showed that a severe sensorimotor axonal neuropathy occurs in eosinophilia-myalgia syndrome, suggestive of mononeuritis multiplex...
- Immunohistochemical analysis of lymphocytes in postmortem study of the heart from fatal cases of the eosinophilia myalgia syndrome and of the toxic oil syndromeT Hayashi
World Health Organization Cardiovascular Center, University of Texas Medical Branch, Galveston 77555 0129
Am Heart J 127:1298-308. 1994....
- Fibrogenic growth factors in the eosinophilia-myalgia syndrome and the toxic oil syndromeL D Kaufman
Department of Medicine, State University of New York at Stony Brook
Arch Dermatol 130:41-7. 1994....
- Eosinophilia-myalgia syndrome: mortality data from the US national surveillance systemL A Swygert
Division of Environmental Hazards and Health Effects, Centers for Disease Control, Atlanta, Georgia
J Rheumatol 20:1711-7. 1993..Older age and involvement of more than one organ system suggest a particularly poor prognosis, and the neuromuscular, pulmonary and cardiovascular sequelae appear to be the most worrisome...
- A decomposition product of a contaminant implicated in L-tryptophan eosinophilia myalgia syndrome affects spinal cord neuronal cell death and survival through stereospecific, maturation and partly interleukin-1-dependent mechanismsD E Brenneman
Section on Developmental and Molecular Pharmacology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
J Pharmacol Exp Ther 266:1029-35. 1993The L-tryptophan eosinophilia myalgia syndrome (L-TRP-EMS), an inflammatory syndrome characterized by eosinophilia, myalgias, perimyositis, fasciitis and neuropathies, occurred in epidemic proportions in the United States in the summer ..
- Eosinophilia-myalgia syndrome: lessons for public health researchersR Taylor
Department of Social and Preventive Medicine, Monash Medical School, Alfred Hospital, Prahran, Vic
Med J Aust 158:51-5. 1993..There may be encumbrances to urgent public health research in the form of inadequate mechanisms of data linkage. It is recommended that attention be given to such barriers now rather than in a time of crisis...
- L-tryptophan and the eosinophilia-myalgia syndrome: current understanding of the etiology and pathogenesisJ Varga
Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
J Invest Dermatol 100:97S-105S. 1993..This tragic outbreak of a newly recognized illness has focused interest on the role of chemical and environmental agents in the pathogenesis of various idiopathic illness characterized by tissue inflammation and fibrosis...
- Production of polyclonal antibodies against 1,1'-ethyliden bis[L-tryptophan] (EBT), a potential contaminant causing eosinophilia-myalgia syndrome (EMS)N Kurihara
Department of Hygiene and Preventive Medicine, Faculty of Medicine, University of Tokyo, Japan
Toxicol Lett 66:231-6. 1993..These antibodies may be available tools for elucidating the mechanisms responsible for the outbreak and/or development of EMS...
- Antiphospholipid antibodies in patients with eosinophilia myalgia and toxic oil syndromeP E Carreira
Rheumatology Department, Hospital 12 de Octubre, Madrid, Spain
J Rheumatol 24:69-72. 1997..of different aPL in patients with toxic oil syndrome (TOS) and compared the profile with patients with eosinophilia myalgia syndrome (EMS)...
- ELECTRON MICROSCOPY OF MYOPATHIESAndrew Engel; Fiscal Year: 1993..In the newly discovered mitochondrial encephalomyopathy due to coenzyme Q10 deficiency, the hypothesis will be tested that the disorder is caused by a defect in the mitochondrial biosynthesis of coenzyme Q10...