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L-トリプトファンに曝された患者におけるエオシノフィリア・ミアルジア症候群
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
まとめ
高用量のL-トリプトファン,特にブランドAは,エオシノフィリア-ミアルジア症候群を発症するリスクを大幅に増加させた. この研究は,L-トリプトファン関連疾患における重要な要因としての用量を強調しています.
科学分野:
- エピデミオロジー エピデミオロジー
- 毒理学 毒理学 毒理学
- クリニカル・メディシン 臨床医学
背景:
- エオシノフィリア-ミアルジア症候群 (EMS) は,L-トリプトファン補給に関連した深刻な状態です.
- EMSの発生率,危険因子,臨床表現を理解することは,公衆衛生にとって極めて重要です.
研究 の 目的:
- L-トリプトファンにさらされた集団におけるEMSの発生率を決定する.
- EMSに関連する特定のブランドや用量を含むリスク要因を特定する.
- L-トリプトファンの使用に関連する疾患の臨床スペクトルを説明するために.
主な方法:
- 遡及的なコホートおよび内蔵症例対照研究が行われました.
- データ収集には,図表のレビューと患者インタビュー (対面および電話) が含まれていました.
- L-トリプトファン使用者の臨床経過に関する記述的研究が行われました.
主要な成果:
- インタビューされた418人のL-トリプトファンの使用者の中で,11%が明確なEMSと16%が潜在的なEMSを持っていた.
- 特定のブランド (ブランドA) の使用は,EMSと強く関連しており,投与量に応じてリスクが増加していました.
- ブランドAのL-トリプトファンの高用量 (4000mg/日以上) は,確固たるまたは可能なEMSの有意に高い割合をもたらしました.
結論:
- L-トリプトファンの用量は,EMSの主要な予測因子であり,特定の製品に汚染があることを示唆しています.
- 暴露された人の有意な割合がEMSを発症し,厳格な症例定義は実際の発生率を過小評価する可能性があります.
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