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EOSINOPHILIA-MYALGIA SYNDROME ASSOCIATED WITH SINGLE TRYPTOPHAN MANUFACTURER.

Eosinophilia-myalgia syndrome (EMS), the connective tissue disorder first reported last year, has been linked to the health-food supplement tryptophan. But how a widely occurring amino acid could cause EMS has been unclear. This epidemiologic study of EMS cases from Oregon suggests that the outbreak in that state is strongly associated with tryptophan from a single Japanese manufacturer, raising the possibility of new insights into the pathogenesis of the disorder.

The investigators compared the brands of tryptophan used by 58 patients with EMS and 93 asymptomatic control subjects, and traced the sources back to the six Japanese companies that manufacture all of the tryptophan sold in the U.S. They found that 98 percent of the EMS cases, compared with 35 percent of the controls, had been exposed to tryptophan from a single manufacturer that was sold under different brand names.

These data indicate that Oregon's EMS outbreak was related to either a contaminant or an alteration in tryptophan introduced in the manufacturing process. Researchers now are trying to identify which of these mechanisms is at work, with the expectation that insight into the pathogenesis of EMS may help in the prevention and treatment of other connective tissue disorders.

— THL

Published in Journal Watch General Medicine July 17, 1990

Citation(s):

Slutsker L et al. Eosinophilia-myalgia syndrome associated with exposure to tryptophan from a single manufacturer. JAMA 1990 Jul 11 264 213-217.

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