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. 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
  6. 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
  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 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
  9. 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
  10. 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

Research Grants

  1. ELECTRON MICROSCOPY OF MYOPATHIES
    Andrew Engel; Fiscal Year: 1993

Scientific Experts

  • S Naylor
  • M J Smith
  • John D Fernstrom
  • T Simat
  • B Gross
  • JOHN M VARGA
  • Joshua Solomon
  • J Finsterer
  • J F Pellissier
  • Erick H Turner
  • Michael Harbuz
  • J Adachi
  • Bernardino Roca
  • P A Hertzman
  • L A Dourmishev
  • James N Allen
  • Tim Higenbottam
  • R Noakes
  • Leon Margolin
  • Henry Falk
  • E Fonseca
  • Gerald Gleich
  • Andrew Engel
  • David Lebeaux
  • S Akanay-Diesel
  • R Foti
  • Tiago de Araujo Guerra Grangeia
  • Hadewijch M Vanhooren
  • Vera Dinić-Uzurov
  • Anna Martínez-Cabot
  • B L Williamson
  • Mariusz Puszczewicz
  • Elizabeth Smith
  • Murielle Dunand
  • Samuel L Moschella
  • Yesu T Das
  • María M Plaza Cano
  • P Sánchez-Porro Valadés
  • Klaus Klarskov
  • Maryanna C Ter Poorten
  • Yasuji Mori
  • R I Horwitz
  • Damien Sene
  • J L Pena Segura
  • S R Daniels
  • M Posada de la Paz
  • D D'Cruz
  • S Hanneken
  • K W Schulte
  • J Reifenberger
  • J Richter
  • M Schneider
  • A Doria
  • C Leonetti
  • M Di Gangi
  • M Canova
  • H Barth
  • R Rondinone
  • N Ronen
  • R Leonardi
  • B Muller
  • Benoit Nemery
  • Mônica Corso Pereira
  • Erik Verbeken
  • Jeroen A Vanoirbeek
  • Ivana Urosevic
  • Marcelo Schweller
  • Lair Zambon
  • Stevan Popović
  • Haiyan Xu
  • Vesna Lalosevic
  • Angel Messeguer
  • J I Hudson
  • Ilma Aparecida Paschoal
  • Ivana Milosević
  • Dusan Lalosevic
  • Marsha Gordon
  • Stanisław Lazowski
  • J D Smith
  • A J Tomlinson
  • L J Haseler
  • Mark Lebwohl
  • Honorata Pietrzak-Kaczmarek
  • Irena Zimmermann-Górska
  • G J Gleich
  • Olivier Spertini
  • L D Kaufman
  • Thierry Kuntzer
  • Johannes A Lobrinus
  • R M Silver

Detail Information

Publications91

  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. 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...
  6. 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...
  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 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.
  9. 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...
  10. 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...
  11. 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
  12. 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...
  13. 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
  14. 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...
  15. 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...
  16. 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...
  17. 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...
  18. 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...
  19. 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...
  20. 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 ..
  21. 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...
  22. 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...
  23. 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...
  24. 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...
  25. 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...
  26. 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.
  27. 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...
  28. 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...
  29. 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...
  30. 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...
  31. 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...
  32. doi 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...
  33. 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
    ....
  34. doi [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...
  35. 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...
  36. ncbi Neurologic, MR imaging, and MR spectroscopic findings in eosinophilia myalgia syndrome
    L J Haseler
    Center for Non Invasive Diagnosis, University of New Mexico Health Sciences Center, Albuquerque, USA
    AJNR Am J Neuroradiol 19:1687-94. 1998
    BACKGROUND AND PURPOSE: Eosinophilia myalgia syndrome (EMS), a multisystemic disease induced by exposure to L-tryptophan, may result in serious CNS abnormalities...
  37. ncbi On-line HPLC-tandem mass spectrometry structural characterization of case-associated contaminants of L-tryptophan implicated with the onset of eosinophilia myalgia syndrome
    B 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...
  38. ncbi Autoimmune diseases associated with drugs, chemicals and environmental factors
    D 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...
  39. ncbi Synthesis and formation of an EMS correlated contaminant in biotechnologically manufactured L-tryptophan
    B 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...
  40. doi 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...
  41. ncbi 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...
  42. 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)...
  43. 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...
  44. 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...
  45. 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...
  46. 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...
  47. 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...
  48. 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
  49. ncbi Possible lansoprazole-induced eosinophilic syndrome
    J 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...
  50. 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...
  51. 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...
  52. 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...
  53. 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...
  54. 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...
  55. 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...
  56. ncbi Peripheral neuropathy associated with eosinophilia-myalgia syndrome
    T 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...
  57. ncbi Continuing occurrence of eosinophilia myalgia syndrome in Canada
    W O Spitzer
    Potsdam Institute of Pharmacoepidemiology and Technology Assessment, Germany
    Br J Rheumatol 34:246-51. 1995
    b>Eosinophilia myalgia syndrome (EMS), was defined by the Centers for Disease Control (CDC) as eosinophilia > 1000 mm3 and incapacitating myalgia without infection or neoplasm...
  58. ncbi Eosinophilic hepatitis: a new feature of the clinical spectrum of the eosinophilia-myalgia syndrome
    P 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...
  59. 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...
  60. 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...
  61. 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...
  62. 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...
  63. 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...
  64. 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...
  65. 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...
  66. 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...
  67. 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
    ....
  68. 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...
  69. 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...
  70. ncbi New cutaneous manifestations of systemic diseases
    S 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...
  71. ncbi Comparative studies on tryptophan binding to hepatic nuclear envelopes in Sprague-Dawley and Lewis rats
    H 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...
  72. 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...
  73. 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...
  74. 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...
  75. ncbi Fibromyalgia, psychiatric disorders, and assessment of the longterm outcome of eosinophilia-myalgia syndrome
    J 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...
  76. ncbi Bias or biology: evaluating the epidemiologic studies of L-tryptophan and the eosinophilia-myalgia syndrome
    R 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...
  77. ncbi Animal models of the eosinophilia-myalgia syndrome
    D 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...
  78. ncbi Effect of L-tryptophan products on function of human eosinophils: investigation of the causal mechanisms of eosinophilia myalgia syndrome associated with L-tryptophan products
    H 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...
  79. ncbi Antiphospholipid antibodies in patients with eosinophilia myalgia and toxic oil syndrome
    P 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)...
  80. 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...
  81. ncbi Epidemiology of potential association between L-tryptophan ingestion and eosinophilia-myalgia syndrome
    S 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...
  82. ncbi Long-term follow-up of patients with diffuse fasciitis and eosinophilia associated with L-tryptophan ingestion
    E 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...
  83. 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...
  84. ncbi Immunohistochemical analysis of lymphocytes in postmortem study of the heart from fatal cases of the eosinophilia myalgia syndrome and of the toxic oil syndrome
    T Hayashi
    World Health Organization Cardiovascular Center, University of Texas Medical Branch, Galveston 77555 0129
    Am Heart J 127:1298-308. 1994
    ....
  85. ncbi Fibrogenic growth factors in the eosinophilia-myalgia syndrome and the toxic oil syndrome
    L D Kaufman
    Department of Medicine, State University of New York at Stony Brook
    Arch Dermatol 130:41-7. 1994
    ....
  86. ncbi Eosinophilia-myalgia syndrome: mortality data from the US national surveillance system
    L 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...
  87. ncbi 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 mechanisms
    D 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. 1993
    The 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 ..
  88. ncbi Eosinophilia-myalgia syndrome: lessons for public health researchers
    R 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...
  89. ncbi L-tryptophan and the eosinophilia-myalgia syndrome: current understanding of the etiology and pathogenesis
    J 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...
  90. ncbi Demonstration of interleukin 8 and autoantibodies to interleukin 8 in the serum of patients with systemic sclerosis and related disorders
    S 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...
  91. pmc Eosinophilia-myalgia syndrome: selective cognitive impairment, longitudinal effects, and neuroimaging findings
    C 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...

Research Grants11

  1. ELECTRON MICROSCOPY OF MYOPATHIES
    Andrew 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...