Peripheral neuropathy in the eosinophilia-myalgia syndrome associated with L-tryptophan ingestion

Benn E. Smith, Peter J Dyck

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Eosinophilia, brawny induration, and tenderness of the skin and deeper tissues, and eosinophilic and lymphocytic infiltration of skin, deep fascia, and muscle characterize the acute eosinophilia-myalgia syndrome associated with ingestion of L-tryptophan. Many patients have a florid inflammatory myopathy. We evaluated 10 patients with this syndrome in whom peripheral neuropathy was a prominent or the only presenting feature. Two of these patients with severe neuromuscular disease required mechanical ventilation, and 1 died. Clinical severity appeared to be positively associated with the total dose of L-tryptophan ingested. Although the inflammation is generally thought to be more severe in skin, fascia, and muscle, inflammation, especially in the epineurium of sural nerve, was sometimes striking and often accompanied by vasculopathy and angioneogenesis. These cases draw attention to a new preventable syndrome with peripheral nerve involvement, emphasize the value of tissue biopsy for its diagnosis, and raise issues related to pathogenesis.

Original languageEnglish (US)
Pages (from-to)1035-1040
Number of pages6
JournalNeurology
Volume40
Issue number7
StatePublished - Jul 1990

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Eosinophilia-Myalgia Syndrome
Peripheral Nervous System Diseases
Tryptophan
Eating
Fascia
Peripheral Nerves
Skin
Inflammation
Muscles
Neuromuscular Diseases
Sural Nerve
Myositis
Eosinophilia
Artificial Respiration
Biopsy

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Peripheral neuropathy in the eosinophilia-myalgia syndrome associated with L-tryptophan ingestion. / Smith, Benn E.; Dyck, Peter J.

In: Neurology, Vol. 40, No. 7, 07.1990, p. 1035-1040.

Research output: Contribution to journalArticle

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