L-tryptophan-related eosinophilia-myalgia syndrome: a case report

Eosinophilia-myalgia syndrome (EMS) is characterized by intense eosinophilia and, very often, debilitating generalized myalgia in the absence of infectious or neoplastic causation. The Centers for Disease Control have established that the latter two features, along with an eosinophil count greater than 1000 cells per cu mm, are criteria for the syndrome. EMS has been reported in epidemic proportions over the last several months. Early data strongly suggested that in at least a small percentage of patients the syndrome leads to death. Epidemiological work in New Mexico, Minnesota, and Oregon has linked EMS most impressively to L-tryptophan-containing products (LTCPS).