L-Tryptophan Ingestion Associated with Eosinophilic Fasciitis but Not Progressive Systemic Sclerosis

Abstract

L-Tryptophan use can lead to eosinophilic fasciitis whereas it does not appear to cause classic scleroderma. The disease process does not automatically remit after discontinuation of L-tryptophan-containing products.

Eosinophilic Fasciitis (Shulman’s Syndrome): Case Reports and Review of the Literature

“…17 Trauma has been reported as a cause and accepted for workers' compensation in France. 18 L-tryptophan is known to be associated with EMS (eosinophilia myalgia syndrome), 19,20 however, 8 patients with a history of L-tryptophan ingestion have been reported in 1990 to have EF. 19 Interestingly, L-tryptophan became available in the United States in 1974, the year in which EF was first described.…”

“…18 L-tryptophan is known to be associated with EMS (eosinophilia myalgia syndrome), 19,20 however, 8 patients with a history of L-tryptophan ingestion have been reported in 1990 to have EF. 19 Interestingly, L-tryptophan became available in the United States in 1974, the year in which EF was first described. 21 Eosinophilia myalgia syndrome (EMS) is a multisystem toxin-induced disorder, and 98% of all patients have a history of ingesting L-trytophan.…”

“…Peripheral eosinophilia is also frequently reported with EF. 19,25 It is defined as eosinophils >7% of total WBC or >760 cells/microliter absolute count. 25 Muscle weakness was reported in 11 out of 15 cases and was judged to be due to mild eosinophilic myositis.…”

Dissecting the enigma of scleroderma: possible involvement of the kynurenine pathway

“…Soon reports of eosinophilia myalgia syndrome [27] and eosinophilic fasciitis [28,29], associated with the ingestion of L-tryptophan were received. Although initially linked to a contaminant in a product made by a single manufacturer [30], authors soon reported the same reaction to L-tryptophan produced by other manufacturers [31].…”

<i>L</i>-Tryptophan Ingestion Does Not Induce Progressive Systemic Sclerosis (Scleroderma)

“…Comparable results were found by Freundlich ct al. [13], In cooperation with the German self-aid group 'Sclero derma'. 137 PSS patients were questioned concerning their E-tryptophan use before the onset of their disease.…”