Eosinophilia–myalgia syndrome

Eosinophilia–myalgia syndrome (EMS) is a rare, sometimes fatal neurological condition linked to the ingestion of the dietary supplement L-tryptophan. The syndrome is characterized by elevated levels of eosinophils (a type of white blood cell) in the blood and severe muscle pain (myalgia).

History

EMS was first identified in the late 1980s when an outbreak of the syndrome occurred in the United States. The outbreak was traced to the consumption of L-tryptophan supplements, which were later found to be contaminated. The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) played crucial roles in identifying and managing the outbreak.

Symptoms

The primary symptoms of EMS include:

• Severe muscle pain (myalgia)
• Elevated levels of eosinophils in the blood (eosinophilia)
• Skin changes such as rashes
• Respiratory issues
• Neurological symptoms such as memory loss and difficulty concentrating

Causes

The exact cause of EMS is not fully understood, but it is strongly associated with the ingestion of contaminated L-tryptophan supplements. The contaminants in these supplements are believed to trigger an abnormal immune response, leading to the symptoms of EMS.

Diagnosis

Diagnosis of EMS is based on clinical symptoms and laboratory findings, including:

• Elevated eosinophil count
• Muscle biopsy showing inflammation
• Exclusion of other conditions that could cause similar symptoms

Treatment

There is no specific cure for EMS, and treatment primarily focuses on managing symptoms. Common treatments include:

• Corticosteroids to reduce inflammation
• Pain management strategies
• Physical therapy to maintain muscle function

Prognosis

The prognosis for individuals with EMS varies. Some patients recover fully with appropriate treatment, while others may experience chronic symptoms or complications. Early diagnosis and treatment are crucial for improving outcomes.

Prevention

The primary prevention strategy for EMS is to avoid the use of L-tryptophan supplements, especially those that are not regulated or tested for purity.

Related Pages

• Eosinophil
• Myalgia
• L-tryptophan
• Centers for Disease Control and Prevention
• Food and Drug Administration