The Eosinophilia-Myalgia Syndrome: Status of 205 Patients and Results of Treatment 2 Years after Onset

Hertzman, Phillip A.; Clauw, Daniel J.; Kaufman, Lee D.; Varga, John; Silver, Richard M.; Thacker, Holly L.; Mease, Philip J; Espinoza, Luis R.; Pincus, Theodore

doi:10.7326/0003-4819-122-11-199506010-00008

Cited by 34 publications

(19 citation statements)

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“…& Anorexigens, including diethylpropion chlorhydrate, mazindol, dexamphetamine-metaqualone, fenproporex, and fenfluramine [79,80,88,[93][94][95]. & Tryptophan [88,[96][97][98].…”

Section: Drugsmentioning

confidence: 99%

Environmental risk factors of systemic sclerosis

Marie

Gehanno

2015

Semin Immunopathol

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Systemic sclerosis (SSc) has a complex pathogenesis. Although, there is a growing evidence that environmental factors have an impact on alterations and modulation of epigenetic determinants, resulting in SSc onset and progression. A marked correlation has thus been found between SSc onset and occupational exposure to crystalline silica and the following organic solvents: white spirit, aromatic solvents, chlorinated solvents, trichloroethylene, and ketones; the risk associated with high cumulative exposure to silica and organic solvents further appears to be strongly increased in SSc. Altogether, occupational exposure should be systematically checked in all SSc patients at diagnosis, as (1) exposed patients seem to develop more severe forms of SSc and (2) the identification of the occupational agents will allow its interruption, which may lead to potential improvement of SSc outcome. By contrast, based on current published data, there is insufficient evidence that exposure to other chemical agents (including notably pesticides as well as personal care such as silicone and hair dye), physical agents (ionizing radiation, ultraviolet radiation, electric and magnetic fields), and biological agents (infections and diet, foods, and dietary contaminants) is a causative factor of SSc. Further investigations are still warranted to identify other environmental factors that may be associated with SSc onset and progression.

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“…& Anorexigens, including diethylpropion chlorhydrate, mazindol, dexamphetamine-metaqualone, fenproporex, and fenfluramine [79,80,88,[93][94][95]. & Tryptophan [88,[96][97][98].…”

Section: Drugsmentioning

confidence: 99%

Environmental risk factors of systemic sclerosis

Marie

Gehanno

2015

Semin Immunopathol

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“…Whereas an association between malignant lymphomas and EF has been reported, a review of long-term surveys of patients with EMS due to Ltryptophan did not show the subsequent occurrence of malignant hematologic disorders to be a possible complication of L-tryptophan or of EMS [3,4,13,17]. Only one case of EMS with later development of a malignant fibrous histiocytoma on previously sclerodermatous skin areas and of an extra-abdominal desmoid tumor has been reported [22].…”

Section: Discussionmentioning

confidence: 97%

“…EMS-or L-tryptophan-related malignant hematologic diseases have not been reported [13]. We describe here a patient with coincident occurrence of B-CLL and EMS following long-term treatment with L-tryptophan.…”

Section: Introductionmentioning

confidence: 86%

l-tryptophan-related eosinophilia-myalgia syndrome possibly associated with a chronic B-lymphocytic leukemia

Böhme

Wolter

Hoelzer

1998

Annals of Hematology

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A female patient presenting with B-CLL and coincident eosinophilia-myalgia syndrome (EMS) after ingestion of L-tryptophan is described. The manifestations of EMS disappeared completely during treatment with cyclophosphamide/prednisone. and there was an intermittent clinical remission of CLL with absence of the monoclonal B-cell population. A few years later, the B-CLL relapsed, but without sign and symptoms of EMS. Whereas other eosinophilic syndromes such as eosinophilic fasciitis, panniculitis, or cellulitis Wells have been found to occur in relation to malignant underlying diseases, only a single patient with malignant fibrous histiocytoma following EMS has been described. There are no reports about an increased occurrence of B-CLL or other non-Hodgkin's lymphomas combined with or following EMS or related to L-tryptophan itself. The variant types of eosinophilic syndromes occurring due to malignant disorders, the differentiation from EMS, and the possible association between B-CLL and L-tryptophan-related EMS are discussed.

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“…Following adrenalectomy, mice become two orders of magnitude more susceptible to histamine intoxication [91,135]; one locus of damage is the microcirculation [298]. One may now begin to perceive why glucocorticoid treatments afforded signifi cant improvement in about 130 (80%) of 163 EMS patients evaluated by physicians [299]. Because another EMS patient had a long history of Crohn's disease [300] it is noteworthy (vis-à-vis metabolic denominators) that mRNA for eotaxin accumulates in lesions of patients with infl ammatory bowel diseases [160]; increased mast cell and basophil activities are integral to these disorders [67].…”

Section: Susceptibility Bias Disease Onset and Additional Metabolic mentioning

confidence: 99%

A heretofore undisclosed crux of Eosinophilia-Myalgia Syndrome: compromised histamine degradation

Smith

Garrett

2005

Inflamm. res.

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In contrast to early epidemiological evidence offering links between eosinophilia-myalgia syndrome (EMS) and microimpurities of L-tryptophan-containing dietary supplements (LTCDS), this account shows why reliance on a finite impurity from one manufacturer is both unnecessary and insufficient to explain the etiology of EMS. Excessive histamine activity has induced blood eosinophilia and myalgia (Greek: mys, muscle + algos, pain). Termination of the multiple actions of histamine is dependent on particular amine oxidases and histamine-N-methyltransferase. Histamine metabolism is rapid when these degradative reactions are operative. The latent effects of incurred histamine can be potentiated and aggravating when these mechanisms are impaired. Overloads of tryptophan supplements cause - among other relevant side-effects - an increased formation of formate and indolyl metabolites, several of which inhibit the degradation of histamine. Moreover, (non-EMS) subjects with hypothalamic-pituitary- adrenal (HPA) axis dysregulation have also manifested greatly increased sensitivities to incurred tryptophan and histamine. A final common pathway for syndromes characterized by eosinophilia with myalgia is now evident.

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The Eosinophilia-Myalgia Syndrome: Status of 205 Patients and Results of Treatment 2 Years after Onset

Cited by 34 publications

References 0 publications

Environmental risk factors of systemic sclerosis

Environmental risk factors of systemic sclerosis

l-tryptophan-related eosinophilia-myalgia syndrome possibly associated with a chronic B-lymphocytic leukemia

A heretofore undisclosed crux of Eosinophilia-Myalgia Syndrome: compromised histamine degradation

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