Myalgia eosinophilia associated with tryptophan

A condition associated with the consumption of L-tryptophan supplements

Myalgia Eosinophilia Syndrome
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Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Severe muscle pain, skin rash, fatigue
Complications	Chronic muscle pain, disability
Onset
Duration
Types	N/A
Causes	Contaminated L-tryptophan supplements
Risks
Diagnosis	Clinical evaluation, blood tests
Differential diagnosis	N/A
Prevention	N/A
Treatment	Discontinuation of tryptophan, corticosteroids
Medication	N/A
Prognosis	Variable
Frequency	Rare
Deaths	N/A

Myalgia Eosinophilia Syndrome (MES) is a rare condition characterized by severe muscle pain (myalgia) and an elevated number of eosinophils in the blood (eosinophilia). This syndrome was notably associated with the consumption of L-tryptophan supplements in the late 1980s.

History

The outbreak of Myalgia Eosinophilia Syndrome was first identified in the United States in 1989. It was linked to the ingestion of L-tryptophan, an amino acid commonly used as a dietary supplement for its purported benefits in improving sleep and mood. The syndrome led to a nationwide recall of L-tryptophan supplements.

Pathophysiology

The exact mechanism by which L-tryptophan caused Myalgia Eosinophilia Syndrome is not fully understood. However, it is believed that contaminants in the manufacturing process of L-tryptophan supplements were responsible for triggering the condition. These contaminants may have induced an abnormal immune response, leading to the symptoms observed in affected individuals.

Clinical Presentation

Patients with Myalgia Eosinophilia Syndrome typically present with:

• Severe muscle pain
• Skin rashes
• Fatigue
• Fever
• Peripheral edema

Laboratory findings often reveal elevated eosinophil counts, which is a hallmark of the syndrome.

Diagnosis

Diagnosis of Myalgia Eosinophilia Syndrome is primarily clinical, supported by laboratory findings of eosinophilia. A detailed patient history, including recent use of L-tryptophan supplements, is crucial for diagnosis.

Treatment

The primary treatment for Myalgia Eosinophilia Syndrome involves the immediate discontinuation of L-tryptophan supplements. Corticosteroids may be administered to reduce inflammation and alleviate symptoms. The prognosis varies, with some patients experiencing chronic symptoms.

Epidemiology

The incidence of Myalgia Eosinophilia Syndrome dramatically decreased following the recall of L-tryptophan supplements. It remains a rare condition, with few cases reported since the initial outbreak.

Prevention

The prevention of Myalgia Eosinophilia Syndrome is primarily through the regulation and monitoring of dietary supplements. Ensuring the purity and safety of L-tryptophan products is essential to prevent future occurrences.

Also see

• Eosinophilia
• L-tryptophan
• Dietary supplement
• Rheumatology