eosinophilia myalgia syndrome

Summary

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)

Top Publications

  1. ncbi Scleroderma-like cutaneous syndromes
    Yasuji 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
  2. ncbi Safety of 5-hydroxy-L-tryptophan
    Yesu T Das
    ISSI Laboratories Inc, 515 Blue Ridge Avenue, Piscataway, NJ 08854, USA
    Toxicol Lett 150:111-22. 2004
  3. ncbi Risk factors for developing eosinophilia myalgia syndrome among L-tryptophan users in New York
    E E Back
    Division of Field Epidemiology, Centers for Disease Control, Albany, NY
    J Rheumatol 20:666-72. 1993
  4. ncbi Is there any relationship between eosinophilia myalgia syndrome (EMS) and fibromyalgia syndrome (FMS)? An analysis of clinical and immunological data
    H Barth
    Department of Internal Medicine, University of Tubingen, Germany
    Adv Exp Med Biol 467:487-96. 1999
  5. ncbi Rapid HPLC screening method for contaminants found in implicated L-tryptophan associated with eosinophilia myalgia syndrome and adulterated rapeseed oil associated with toxic oil syndrome
    B L Williamson
    Department of Biochemistry and Molecular Biology, Mayo Clinic Foundation, Rochester, MN 55905, USA
    Biomed Chromatogr 12:255-61. 1998
  6. pmc Enhanced collagen synthesis and transcription by peak E, a contaminant of L-tryptophan preparations associated with the eosinophilia myalgia syndrome epidemic
    H Takagi
    University of Miami School of Medicine, Department of Dermatology and Cutaneous Surgery, Florida 33136, USA
    J Clin Invest 96:2120-5. 1995
  7. ncbi A heretofore undisclosed crux of eosinophilia-myalgia syndrome: compromised histamine degradation
    M 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
  8. ncbi Calcinosis cutis in a patient with eosinophilia-myalgia syndrome: case report
    Elizabeth Smith
    Department of Dermatology, Mount Sinai Medical Center, One Gustave L Levy Place, New York, NY 10029, USA
    Cutis 77:361-4. 2006
  9. ncbi [Diagnostic problems in eosinophilic fasciitis]
    Mariusz Puszczewicz
    Katedra i Klinika Reumatologiczno Rehabilitacyjna i Chorób Wewnetrznych AM
    Pol Arch Med Wewn 116:777-80. 2006
  10. ncbi Structural characterization of a case-implicated contaminant, "Peak X," in commercial preparations of 5-hydroxytryptophan
    Klaus Klarskov
    Biomedical Mass Spectrometry and Functional Proteomics Facility, Mayo Clinic, Rochester, Minnesota, USA
    J Rheumatol 30:89-95. 2003

Scientific Experts

Detail Information

Publications127 found, 100 shown here

  1. ncbi Scleroderma-like cutaneous syndromes
    Yasuji 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...
  2. ncbi Safety of 5-hydroxy-L-tryptophan
    Yesu 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...
  3. ncbi Risk factors for developing eosinophilia myalgia syndrome among L-tryptophan users in New York
    E E Back
    Division of Field Epidemiology, Centers for Disease Control, Albany, NY
    J Rheumatol 20:666-72. 1993
    Using a case-control study design, patients with eosinophilia myalgia syndrome (EMS) who had used L-tryptophan (LT) were compared with LT users who did not develop EMS...
  4. ncbi Is there any relationship between eosinophilia myalgia syndrome (EMS) and fibromyalgia syndrome (FMS)? An analysis of clinical and immunological data
    H 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...
  5. ncbi Rapid HPLC screening method for contaminants found in implicated L-tryptophan associated with eosinophilia myalgia syndrome and adulterated rapeseed oil associated with toxic oil syndrome
    B 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...
  6. pmc Enhanced collagen synthesis and transcription by peak E, a contaminant of L-tryptophan preparations associated with the eosinophilia myalgia syndrome epidemic
    H Takagi
    University of Miami School of Medicine, Department of Dermatology and Cutaneous Surgery, Florida 33136, USA
    J Clin Invest 96:2120-5. 1995
    The pathogenesis of the eosinophilia myalgia syndrome (EMS) remains unclear...
  7. ncbi A heretofore undisclosed crux of eosinophilia-myalgia syndrome: compromised histamine degradation
    M 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...
  8. ncbi Calcinosis cutis in a patient with eosinophilia-myalgia syndrome: case report
    Elizabeth 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...
  9. ncbi [Diagnostic problems in eosinophilic fasciitis]
    Mariusz Puszczewicz
    Katedra i Klinika Reumatologiczno Rehabilitacyjna i Chorób Wewnetrznych AM
    Pol Arch Med Wewn 116:777-80. 2006
    ..The difficulties in differentition of the symptoms between eosinophilic fasciitis and "eosinophilia-myalgia syndrome" are discussed...
  10. ncbi Structural characterization of a case-implicated contaminant, "Peak X," in commercial preparations of 5-hydroxytryptophan
    Klaus Klarskov
    Biomedical Mass Spectrometry and Functional Proteomics Facility, Mayo Clinic, Rochester, Minnesota, USA
    J Rheumatol 30:89-95. 2003
    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-OHTrp.
  11. ncbi Part II. Eosinophilia-Myalgia Syndrome: further correlations between compromised histamine degradation, eosinophilias and myopathies
    M 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
  12. ncbi 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 skin
    Samuel L Moschella
    Department of Dermatology, Lahey Clinic, Burlington, Mass, USA
    N Engl J Med 351:2219-27. 2004
  13. ncbi [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...
  14. ncbi Drug-induced eosinophilic lung disease
    James 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...
  15. ncbi Toxic oil syndrome: survival in the whole cohort between 1981 and 1995
    P 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...
  16. ncbi Pulmonary hypertension as a result of drug therapy
    Tim 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...
  17. ncbi [Current differential diagnosis of hypereosinophilic syndrome]
    Vera Dinić-Uzurov
    Klinika za hematologiju, Klinicki centar Vojvodine, Novi Sad
    Med Pregl 60:581-6. 2007
    ..g. involvement of the heart, lungs, skin, or nervous tissue...
  18. ncbi [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...
  19. ncbi Tetrahydro-beta-carboline-3-carboxylic acids and contaminants of L-tryptophan
    J 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...
  20. ncbi 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...
  21. ncbi Miliary tuberculosis in a patient with eosinophilic fasciitis
    Bernardino 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...
  22. ncbi Neuromuscular disorders associated with apical hypertrophic cardiomyopathy
    Josef Finsterer
    Krankenanstalt Rudolfstiftung, Vienna, Austria
    Acta Cardiol 64:85-9. 2009
    ..Cardiomyopathy is a frequent manifestation of neuromuscular disorders...
  23. ncbi Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophan
    Erick 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.
  24. ncbi The hypothalamic-pituitary-adrenal axis in autoimmunity
    M 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...
  25. ncbi Absent neutrophil alkaline phosphatase in the eosinophilia myalgia syndrome associated with L-tryptophan use
    J 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...
  26. ncbi Drug-, toxin-, and radiation therapy-induced eosinophilic pneumonia
    Joshua 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...
  27. pmc Detection of antineutrophil cytoplasmic antibody in a patient with L-tryptophan induced eosinophilia-myalgia syndrome
    A M Cilursu
    Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City 52242
    Ann Rheum Dis 50:817-9. 1991
    ..The case is reported of eosinophilia-myalgia syndrome and polyneuropathy associated with myeloperoxidase specific antineutrophil cytoplasmic antibody...
  28. ncbi A diagnostic algorithm for distinguishing the eosinophilia-myalgia syndrome from fibromyalgia and chronic myofascial pain
    R M Taylor
    Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
    J Rheumatol Suppl 46:13-8. 1996
    ..5 and 97.9%, respectively. CONCLUSION: This algorithm is practical and can be easily applied in any medical setting. It also readily distinguishes EMS from other common myalgia syndromes...
  29. ncbi Chronic fatigue: a peculiar evolution of eosinophilia myalgia syndrome following treatment with L-tryptophan in four Italian adolescents
    R Priori
    Istituto di Clinica Medica I, , Roma, Italy
    Eur J Pediatr 153:344-6. 1994
    ..and subsequent to the development of a transient rise in eosinophil count and severe myalgia (Eosinophilia Myalgia Syndrome-EMS). Their clinical picture was indistinguishable from that of the so-called Chronic Fatigue Syndrome...
  30. ncbi [L-tryptophan-associated chronic eosinophilia-myalgia syndrome treated with cyclosporin]
    S Schubert
    , Bad Kreuznach
    Z Rheumatol 51:158-62. 1992
    After 2 weeks of ingestion of 130 g L-Tryptophan a 52 year old female develops an Eosinophilia Myalgia Syndrome with acute onset of deep venous thrombosis of forearm and possible initial cardiac manifestation featuring intermittent ..
  31. ncbi Eosinophilia-myalgia syndrome, eosinophilic fasciitis, and related fibrosing disorders
    J Varga
    Section of Rheumatology, University of Illinois College of Medicine, Chicago 60607 7171, USA
    Curr Opin Rheumatol 9:562-70. 1997
    ..In addition, humoral and cellular autoimmunity may also be implicated...
  32. ncbi Neurocognitive dysfunction in the eosinophilia-myalgia syndrome
    L B Krupp
    Department of Neurology, State University of New York, Stony Brook 11794
    Neurology 43:931-6. 1993
    ..These data support the hypothesis that EMS is associated with an encephalopathy in addition to its previously recognized peripheral neuropathy and other rheumatologic manifestations...
  33. ncbi The eosinophilia-myalgia syndrome: status of 205 patients and results of treatment 2 years after onset
    P A Hertzman
    Los Alamos Medical Center, New Mexico, USA
    Ann Intern Med 122:851-5. 1995
    ..Cognitive changes were reported to be worse in 32% of patients. Prednisone was helpful in the acute phase of illness. No treatment was clearly valuable in management of the later phase of the syndrome...
  34. ncbi 3-anilino-L-alanine, structural determination of UV-5, a contaminant in EMS-associated L-tryptophan samples
    Y Goda
    National Institute of Hygienic Sciences NIHS, Tokyo, Japan
    Chem Pharm Bull (Tokyo) 40:2236-8. 1992
    ..The compound was optically active, and the stereochemistry of alanine moiety was determined as L, by comparing the specific rotation with a synthesized 3-anilino-L-alanine...
  35. ncbi Eosinophilia-myalgia syndrome and fasciitis with an active alveolitis
    D Chauhan
    Pulmonary Section, Eisenhower DVA Medical Center, Leavenworth, Kansas 66048
    Kans Med 94:175-7. 1993
    ..These might include diffusing capacity, gallium scans of lungs, broncho-alveolar lavage and possibly lung biopsy...
  36. ncbi 1,1'-Ethylidenebis[L-tryptophan], a contaminant implicated in L-tryptophan eosinophilia myalgia syndrome, suppresses mRNA expression of hypothalamic corticotropin-releasing hormone in Lewis (LEW/N) rat brain
    L S Brady
    Clinical Neuroendocrinology Branch, National Institute of Mental Health, Bethesda, MD 20892, USA
    Neuroimmunomodulation 1:59-65. 1994
    The L-tryptophan eosinophilia myalgia syndrome (L-Trp-EMS), related to ingestion of impure L-Trp, occurred in epidemic proportions in the United States in 1989...
  37. ncbi Cardiac abnormalities in the toxic oil syndrome, with comparative observations on the eosinophilia-myalgia syndrome
    T N James
    World Health Organization Cardiovascular Center, Galveston, Texas
    J Am Coll Cardiol 18:1367-79. 1991
    ..In both diseases there is good reason to anticipate more clinical cardiac difficulties than have so far been reported, and even more basis for future concern, especially relative to coronary disease and cardiac electrical instability...
  38. ncbi Eosinophilia-myalgia syndrome associated with L-tryptophan. A case report with pulmonary manifestations and review of the literature
    M Andre
    Service de Medecine Interne, Clinique Notre Dame, Charleroi
    Acta Clin Belg 46:178-82. 1991
    ..The withdrawal of the substance and corticotherapy generally lead to complete recovery although several deaths have been reported...
  39. ncbi Repeated coronary artery spasm in a young woman with the eosinophilia-myalgia syndrome
    P A Hertzman
    Los Alamos Medical Center, NM 87544
    JAMA 267:2932-4. 1992
    ....
  40. ncbi Increased type I collagen gene expression in L-tryptophan associated eosinophilia-myalgia syndrome skin fibroblasts
    J Varga
    Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107
    J Rheumatol 20:1303-8. 1993
    ..These biochemical and molecular alterations may result in accumulation of collagen and lead to the cutaneous fibrosis in EMS...
  41. ncbi L-tryptophan-induced eosinophilia-myalgia syndrome associated with primary cutaneous malignant fibrous histiocytoma and extraabdominal desmoid tumor
    C Mainetti
    Department of Dermatology, , Geneva, Switzerland
    Cancer 72:2712-5. 1993
    ..We suspect that these two connective tissue tumors in this patient were related to the exposure to contaminated L-tryptophan, which interfered with connective tissue metabolism...
  42. ncbi Central nervous system involvement in the eosinophilia-myalgia syndrome
    J Lynn
    Department of Neurology, Ohio State University College of Medicine, Columbus 43210
    Arch Neurol 49:1082-5. 1992
    ..Neuropsychological evaluation should be performed in patients with cognitive complaints to delineate the full spectrum of central nervous system impairment associated with the eosinophilia-myalgia syndrome...
  43. ncbi The eosinophilia-myalgia syndrome: current concepts and future directions
    L D Kaufman
    Division of Allergy, Rheumatology, and Clinical Immunology, State University of New York, Stony Brook 11794 8161
    Clin Exp Rheumatol 10:87-91. 1992
    ..Rational therapy will be dependent upon a more complete understanding of the pathogenesis of this and related diseases...
  44. ncbi Comparison of the pathology of fascia in eosinophilic myalgia syndrome patients and idiopathic eosinophilic fasciitis
    I Umbert
    Department of Dermatopathology and Laboratory Medicine, Mayo Clinic, Scottsdale, Ariz
    Dermatology 186:18-22. 1993
    ..The differences may be due to sampling and to sample size. The nerve lesions of EMS may result from the nature of lymphocyte-macrophage inflammation, or the effect of the eosinophil neurotoxin and may not be a primary event...
  45. ncbi Epidemiologic studies of the association of L-tryptophan with the eosinophilia-myalgia syndrome: a critique
    S Shapiro
    Slone Epidemiology Unit, Boston University School of Medicine, USA
    J Rheumatol Suppl 46:44-58; discussion 58-9. 1996
    ..The questionable validity of these studies considerably weakens the claim that LT or a contaminant caused EMS...
  46. ncbi [The tryptophan-associated eosinophilia-myalgia syndrome. A clinical follow-up of 8 patients]
    R M Szeimies
    ,
    Dtsch Med Wochenschr 118:213-20. 1993
    ..1 months. Treatment with penicillin G (20 mega-units daily for 14 days), azathioprine (100 mg daily for 2 months) or cyclosporin (2.5 mg/kg.day) was tried in some cases but had no significant effect...
  47. ncbi Eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fasciitis with eosinophilia
    L D Kaufman
    Department of Medicine, State University of New York at Stony Brook 11794 8161, USA
    Curr Opin Rheumatol 7:560-7. 1995
    ..The formation of the Environmentally Associated Connective Tissue Disease Study Group within the American College of Rheumatology will provide a forum for the development of registries to study suspected toxin-induced disorders...
  48. ncbi A contaminant of L-tryptophan enhances expression of dermal collagen in a murine model of eosinophilia myalgia syndrome
    S Suzuki
    Department of Medicine, Medical University of South Carolina, Charleston, 29425 2229, USA
    Proc Assoc Am Physicians 108:315-22. 1996
    ..This animal model provides additional evidence for EBT as a causal agent of the eosinophilia-myalgia syndrome and should prove useful in the study of the pathogenesis of that syndrome...
  49. ncbi Pathophysiology of the eosinophilia-myalgia syndrome
    R M Silver
    Department of Medicine, Medical University of South Carolina, Charleston 29425, USA
    J Rheumatol Suppl 46:26-36. 1996
    ..The pathophysiology of the chronic symptoms is poorly understood but may involve ischemia, neuropathy, and metabolic abnormalities...
  50. ncbi 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 syndrome
    Anna 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...
  51. ncbi Structural characterization of contaminants found in commercial preparations of melatonin: similarities to case-related compounds from L-tryptophan associated with eosinophilia-myalgia syndrome
    B L Williamson
    Biomedical Mass Spectrometry Facility and Department of Biochemistry and Molecular Biology, Mayo Clinic Foundation, Rochester, Minnesota 55905, USA
    Chem Res Toxicol 11:234-40. 1998
    ..Although there has not been a major outbreak of EMS-like symptoms from consumption of melatonin, this study clearly suggests that tighter control and regulation of nutritional supplements sold and used as drugs is necessary...
  52. ncbi Aspects of melatonin manufacturing and requirements for a reliable active component
    R Laforce
    Helsinn Chemicals SA, Biasca, Switzerland
    Biol Signals Recept 8:143-6. 1999
    ..To avoid any side effects from impurities, only high-purity melatonin should be utilized from the laboratory through to commercialization...
  53. ncbi 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...
  54. ncbi Oxidative damage in rat tissue following excessive L-tryptophan and atherogenic diets
    N 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 ..
  55. ncbi Structural characterization of contaminants in commercial preparations of melatonin by on-line HPLC-electrospray ionization-tandem mass spectrometry
    S 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...
  56. ncbi Tryptophan-induced lung disease: an immunophenotypic, immunofluorescent, and electron microscopic study
    H D Tazelaar
    Department of Pathology, Mayo Clinic, Rochester, Minnesota
    Mod Pathol 6:56-60. 1993
    ..The results of this study indicate that T cytotoxic/suppressor cells may be intimately involved in the pathogenesis of the lung injury...
  57. ncbi Eosinophilia-myalgia syndrome: coming to grips with a new illness
    E M Kilbourne
    Epidemiology Program Office, Centers for Disease Control, Atlanta, GA 30333
    Epidemiol Rev 14:16-36. 1992
    ..Control measures were introduced rapidly, effectively stopping the epidemic...
  58. ncbi Eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fasciitis with eosinophilia
    R M Silver
    Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston 29425
    Curr Opin Rheumatol 4:851-6. 1992
    ..These studies are reviewed, and comparisons to the related syndromes, toxic-oil syndrome and diffuse fasciitis with eosinophilia, are made...
  59. ncbi Eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fasciitis with eosinophilia
    R M Silver
    Department of Medicine, Medical University of South Carolina, Charleston 29425
    Curr Opin Rheumatol 5:802-8. 1993
    ..These and other important advances in the understanding of eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fasciitis with eosinophilia are presented...
  60. ncbi [A case of the eosinophilia-myalgia syndrome]
    A Ishikawa
    School of Medicine, Kitasato University, Kanagawa
    Ryumachi 32:327-30; discussion 330-2. 1992
    ..to Dec. 1989, which contained the amino acid L-tryptophan. On the basis of these findings, we diagnosed her as EMS. It is suggested that this case is rare and important in Japan...
  61. ncbi Magnesium deficiency in the eosinophilia-myalgia syndrome. Report of clinical and biochemical improvement with repletion
    D J Clauw
    Georgetown University Medical Center, Washington, DC
    Arthritis Rheum 37:1331-4. 1994
    ..Low tissue levels of magnesium, even in the setting of normal serum levels, may lead to the neuromuscular symptoms in EMS and related disorders...
  62. ncbi The eosinophilia-myalgia syndrome: the Los Alamos Conference
    P 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...
  63. ncbi Eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fasciitis with eosinophilia
    M B Bolster
    Medical University of South Carolina, Division of Rheumatology and Immunology, Charleston 29425 2229
    Curr Opin Rheumatol 6:642-9. 1994
    ..Follow-up data detailing the long-term sequelae and mortality rates for these two conditions are becoming available. The results from these studies are reviewed in this paper...
  64. ncbi Eosinophilia-myalgia syndrome: a long-term follow-up study
    D S Campbell
    Environmental Epidemiology Section, North Carolina Department of Environment, Health, and Natural Resources, Raleigh, USA
    South Med J 88:953-8. 1995
    ..We conclude that for the majority of patients, EMS is a chronic illness having a major impact on life-style 3.6 years after onset. The chronic, often worsening pattern of illness suggests an ongoing pathogenetic mechanism...
  65. ncbi Eosinophilia-myalgia syndrome not associated with the ingestion of nutritional supplements
    D J Clauw
    Department of Medicine, Georgetown University Medical Center, Washington, DC 20007
    J Rheumatol 21:2385-7. 1994
    ..We postulate that EMS can occur in association with the ingestion of multiple substances that share minute quantities of a common, as yet unidentified, toxin(s), and that metabolic host factors may contribute to disease susceptibility...
  66. pmc A murine model of the eosinophilia-myalgia syndrome induced by 1,1'-ethylidenebis (L-tryptophan)
    R M Silver
    Department of Medicine, Medical University of South Carolina, Charleston 29425
    J Clin Invest 93:1473-80. 1994
    ..This murine model suggests that EBT may have been one of the mediators of EMS and should facilitate studies of the pathogenesis of EMS...
  67. ncbi Clinical improvement of the myopathy in eosinophilia-myalgia syndrome with steroids and rehabilitative therapy
    J J Esper
    Oakland General Hospital, Madison Heights, Mich
    J Am Osteopath Assoc 92:1056-8. 1992
    ..After a course of high-dose steroids with long-term tapering and vigorous inpatient and outpatient rehabilitation, the patient was able to walk and function independently within 2 months...
  68. ncbi Eosinophilic fasciitis (Shulman disease)
    David Lebeaux
    Paris Diderot Paris VII University, Department of Internal Medicine, Saint Louis Lariboisière Fernand Widal Hospital Group, Paris, France
    Best Pract Res Clin Rheumatol 26:449-58. 2012
    ..However, oral corticosteroids remain the mainstay treatment and may be associated to an immunosuppressive drug such as methotrexate in patients with morphea-like lesions or an unsatisfactory response to corticosteroids alone...
  69. ncbi Tryptophan metabolism via the kynurenine pathway in patients with the eosinophilia-myalgia syndrome
    R 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...
  70. ncbi Tryptophan toxicity: a pharmacoepidemiologic review of eosinophilia-myalgia syndrome
    D 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...
  71. ncbi Demyelinating polyneuropathy in eosinophilia-myalgia syndrome
    P 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...
  72. ncbi [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...
  73. ncbi L-tryptophan-induced eosinophilia-myalgia syndrome. I. Report of two cases with pseudoxanthoma-elasticum-like skin changes
    C 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...
  74. ncbi Non-L-tryptophan related eosinophilia-myalgia syndrome with hypoproteinemia and hypoalbuminemia
    Leon Margolin
    Department of Medicine, Rabin Medical Center, Petah Tiqva, Israel
    J Rheumatol 30:628-9. 2003
  75. ncbi Central and peripheral nervous system involvement in the L-tryptophan associated eosinophilia myalgia syndrome
    L 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...
  76. ncbi Autoantibodies to nuclear lamin C in the eosinophilia-myalgia syndrome associated with L-tryptophan ingestion
    J 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...
  77. ncbi Panniculitis
    Maryanna 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
    ....
  78. ncbi Eosinophilia caused by administration of L-tryptophan to animals with adrenal dysfunction
    T 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...
  79. ncbi [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...
  80. ncbi Corticosteroid-induced juxta-articular adiposis dolorosa
    S 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...
  81. ncbi Drug-related lupus
    E 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...
  82. ncbi [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...
  83. ncbi Eosinophilia-myalgia syndrome not associated with L-tryptophan
    M 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...
  84. ncbi The toxic oil syndrome (TOS, 1981): from the disease towards a toxicological understanding of its chemical aetiology and mechanism
    W 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...
  85. ncbi L-tryptophan syndrome: histologic features of scleroderma-like skin changes
    S 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...
  86. ncbi Alterations in tryptophan metabolism in the toxic oil syndrome and in the eosinophilia-myalgia syndrome
    R M Silver
    Department of Medicine, Medical University of South Carolina, Charleston 29425
    J Rheumatol 19:69-73. 1992
    ....
  87. ncbi L-tryptophan-associated eosinophilic fasciitis prior to the 1989 eosinophilia-myalgia syndrome outbreak
    J 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...
  88. ncbi Scleroderma-like disorders
    R 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...
  89. ncbi Activity of certain drugs in inducing of inflammatory myopathies with cutaneous manifestations
    Lyubomir 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...
  90. ncbi Eosinophilic perimyositis as the presenting feature of a monoclonal T-cell expansion
    Murielle 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...
  91. ncbi [Polyneuropathy and fasciitis in eosinophilia-myalgia syndrome]
    W Hetzel
    Neurologische Abteilung,
    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...
  92. ncbi Cutaneous manifestations of the eosinophilia-myalgia syndrome
    J 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...
  93. ncbi L-tryptophan-induced eosinophilia-myalgia syndrome. II. Partial correction of abnormal tryptophan metabolism by pyridoxine
    C 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...
  94. ncbi Rigorous new approach to constructing a gold standard for validating new diagnostic criteria, as exemplified by the eosinophilia-myalgia syndrome
    P 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...
  95. ncbi Eosinophilic fasciitis is clinically distinguishable from the eosinophilia-myalgia syndrome and is not associated with L-tryptophan use
    J 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...
  96. ncbi Tryptophan toxicity--time and dose response in rats
    B 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)...
  97. ncbi Axonal neuropathy in eosinophilia-myalgia syndrome
    S 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...
  98. ncbi Eosinophilia-myalgia syndrome among the non-L-tryptophan users and pre-epidemic cases
    E 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...
  99. ncbi Eosinophilic fasciitis: report of a case diagnosed 14 years after its onset
    B 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...
  100. ncbi 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 vitro
    J 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...
  101. ncbi Analytical characterization of peptide contaminants of L-tryptophan
    E 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...