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Síndrome de eosinophilia-mialgia en pacientes expuestos al L-triptófano
M L Kamb1, J J Murphy, J L Jones
1Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Atlanta, Ga. 30333.
JAMA
|January 1, 1992
Resumen
Las dosis altas de L-triptófano, particularmente la marca A, aumentaron significativamente el riesgo de desarrollar síndrome de eosinofilia-mialgia. Este estudio destaca la dosis como un factor clave en las enfermedades asociadas al L-triptófano.
Área de la Ciencia:
- Epidemiología La epidemiología.
- Toxicología Toxicología.
- La medicina clínica es la medicina clínica.
Sus antecedentes:
- El síndrome de eosinophilia-mialgia (EMS) es una afección grave relacionada con la suplementación con L-triptófano.
- Comprender la incidencia, los factores de riesgo y la presentación clínica del SME es crucial para la salud pública.
Objetivo del estudio:
- Para determinar la incidencia de EMS en una población expuesta al L-triptófano.
- Identificar los factores de riesgo, incluidas marcas y dosis específicas, asociados con el SME.
- Para describir el espectro clínico de enfermedades relacionadas con el uso de L-triptófano.
Principales métodos:
- Se llevaron a cabo estudios retrospectivos de cohortes y estudios de casos y controles anidados.
- La recopilación de datos incluyó revisiones de gráficos y entrevistas con pacientes (en persona y por teléfono).
- Se realizó un estudio descriptivo del curso clínico de los usuarios de L-triptófano.
Principales resultados:
- Entre los 418 usuarios de L-triptófano entrevistados, el 11% tenía EMS definido y el 16% tenía posible EMS.
- El uso de una marca específica (marca A) se asoció fuertemente con la EMS, con un riesgo que aumentaba con la dosis.
- Las dosis más altas de la marca A L-triptófano (más de 4000 mg / día) llevaron a tasas significativamente más altas de EMS definitivo o posible.
Conclusiones:
- La dosis de L-triptófano es el principal predictor de la EMS, lo que sugiere la contaminación en ciertos productos.
- Una proporción significativa de individuos expuestos puede desarrollar EMS, y las definiciones estrictas de casos podrían subestimar la incidencia real.
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