545 results match your criteria Eosinophilia-Myalgia Syndrome


Peak AAA fatty acid homolog contaminants present in the dietary supplement l-Tryptophan associated with the onset of eosinophilia-myalgia syndrome.

Toxicol Lett 2018 Sep 22;294:193-204. Epub 2018 May 22.

ReNeuroGen LLC, Milwaukee, WI, 53122, USA. Electronic address:

The eosinophilia-myalgia syndrome (EMS) outbreak that occurred in the USA and elsewhere in 1989 was caused by the ingestion of Showa Denko K.K. (SD) L-tryptophan (L-Trp). Read More

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September 2018
13 Reads

Structure determination of disease associated peak AAA from l-Tryptophan implicated in the eosinophilia-myalgia syndrome.

Toxicol Lett 2018 Jan 14;282:71-80. Epub 2017 Oct 14.

ReNeuroGen LLC, Milwaukee, WI 53122, USA. Electronic address:

The eosinophilia-myalgia syndrome (EMS) outbreak of 1989 that occurred in the USA and elsewhere was caused by the ingestion of l-Tryptophan (L-Trp) solely manufactured by the Japanese company Showa Denko K.K. (SD). Read More

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January 2018
18 Reads

Possible Parkinson's Disease Induced by Chronic Manganese Supplement Ingestion.

Authors:
Michael J Schuh

Consult Pharm 2016 Dec;31(12):698-703

Objective: The objective is to report a case of possible neurotoxicity resulting from an incorrect dietary supplement for osteoporosis taken at a toxic dose.

Summary: The case study examined here is a 37-year-old African-American female who consumed excessive manganese over a period of years, resulting in Parkinson's disease (PD). This patient was referred to the pharmacist pharmacotherapy service by a neurology physician. Read More

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December 2016
5 Reads

The Importance of Quality Specifications in Safety Assessments of Amino Acids: The Cases of l-Tryptophan and l-Citrulline.

J Nutr 2016 Dec 9;146(12):2643S-2651S. Epub 2016 Nov 9.

US Pharmacopeial Convention, Rockville, MD.

The increasing consumption of amino acids from a wide variety of sources, including dietary supplements, natural health products, medical foods, infant formulas, athletic and work-out products, herbal medicines, and other national and international categories of nutritional and functional food products, increases the exposure to amino acids to amounts far beyond those normally obtained from the diet, thereby necessitating appropriate and robust safety assessments of these ingredients. Safety assessments of amino acids, similar to all food constituents, largely rely on the establishment of an upper limit [Tolerable Upper Intake Level (UL)] considered to be a guide for avoiding high intake, above which adverse or toxic effects might occur. However, reliable ULs have been difficult or impossible to define for amino acids because of inadequate toxicity studies in animals and scarce or missing clinical data, as well as a paucity or absence of adverse event reporting data. Read More

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December 2016
14 Reads

[Eosinophilic fasciitis (Shulman's disease): Diagnostic and therapeutic review].

Authors:
D Sène

Rev Med Interne 2015 Nov 16;36(11):738-45. Epub 2015 Sep 16.

Université Paris-Cité Sorbonne Paris-Diderot, 75013 Paris, France; Service de médecine interne, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. Electronic address:

Eosinophilic fasciitis (EF) is a rare connective tissue disease characterized by symmetrical and painful swelling with a progressive induration and thickening of the skin and soft tissues. The diagnosis of EF is often based on the association of characteristic skin or subcutaneous abnormalities and a thickened fascia with an inflammatory infiltration, mostly composed of lymphocytes and eosinophils. A peripheral eosinophilia is frequently present (60-90%) but is not mandatory for the EF diagnosis. Read More

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November 2015
17 Reads

Eosinophilia in Rheumatologic/Vascular Disorders.

Immunol Allergy Clin North Am 2015 Aug 17;35(3):453-76. Epub 2015 Jun 17.

Department of Rheumatic and Immunologic Diseases, Center for Vasculitis Care and Research, Cleveland Clinic, 9500 Euclid Avenue, A50, Cleveland, OH 44195, USA. Electronic address:

Peripheral and tissue eosinophilia can be a prominent feature of several unique rheumatologic and vascular diseases. These diseases span a wide range of clinical features, histologic findings, therapeutic approaches, and outcomes. Despite the rare nature of these entities--which makes large-scale studies challenging--knowledge has continued to grow regarding their epidemiology, pathophysiology, and management. Read More

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August 2015
14 Reads

Prediction of drug-induced eosinophilia adverse effect by using SVM and naïve Bayesian approaches.

Med Biol Eng Comput 2016 Mar 5;54(2-3):361-9. Epub 2015 Jun 5.

College of Life Science, Northwest Normal University, Lanzhou, 730070, Gansu, People's Republic of China.

Drug-induced eosinophilia is a potentially life-threatening adverse effect; clinical manifestations, eosinophilia-myalgia syndrome, mainly include severe skin eruption, fever, hematologic abnormalities, and organ system dysfunction. Using experimental methods to evaluate drug-induced eosinophilia is very complicated, time-consuming, and costly in the early stage of drug development. Thus, in this investigation, we established computational prediction models of drug-induced eosinophilia using SVM and naïve Bayesian approaches. Read More

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March 2016
13 Reads

[Eosinophilic fasciitis].

Postepy Hig Med Dosw (Online) 2015 Jan 2;69:488-95. Epub 2015 Jan 2.

Katedra i Klinika Reumatologii i Chorób Wewnętrznych Uniwersytetu Medycznego w Poznaniu.

Eosinophilic fasciitis is a rare connective tissue disease with unclear etiology and pathogenesis. It is classified as a scleroderma-like syndrome. The disease is characterized by fibrosis of the skin and subcutaneous tissues with significant thickening of fascia. Read More

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January 2015
37 Reads

Immunohistochemical studies of the kynurenine pathway in morphea.

Int J Tryptophan Res 2013 23;6:97-102. Epub 2013 Dec 23.

Zenith Specialist Pathology, South Brisbane, Queensland, Australia.

Cutaneous sclerosis, resembling that seen in subcutaneous morphea, is a feature of eosinophilic fasciitis and eosinophilia-myalgia syndrome, two conditions in which the kynurenine pathway is known to be activated. To investigate the possibility of activation of the kynurenine pathway in morphea, skin biopsies were taken from involved and non-involved sites in a series of three patients with morphea. Immunohistochemical stains for quinolinic acid and indoleamine 2,3-dioxygenase (IDO) were performed. Read More

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January 2014
4 Reads

Severe eosinophilic syndrome associated with the use of probiotic supplements: a new entity?

Case Rep Rheumatol 2012 6;2012:934324. Epub 2012 Dec 6.

Jefferson Institute of Molecular Medicine and Scleroderma Center, Thomas Jefferson University, Philadelphia, PA 19107, USA ; Rheumatology Division, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.

Severe eosinophilic syndromes related to the administration or use of unsuspected immunogenic substances have been described previously. Many of these diseases presented initially as clusters or isolated cases. The spanish toxic oil syndrome, the eosinophilia myalgia syndrome, and nephrogenic systemic fibrosis are examples of such diseases. Read More

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December 2012
7 Reads

Effects and side effects associated with the non-nutritional use of tryptophan by humans.

Authors:
John D Fernstrom

J Nutr 2012 Dec 17;142(12):2236S-2244S. Epub 2012 Oct 17.

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

The daily nutritional requirement for L-tryptophan (Trp) is modest (5 mg/kg). However, many adults choose to consume much more, up to 4-5 g/d (60-70 mg/kg), typically to improve mood or sleep. Ingesting L-Trp raises brain tryptophan levels and stimulates its conversion to serotonin in neurons, which is thought to mediate its actions. Read More

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December 2012
4 Reads

Eosinophilic fasciitis (Shulman disease).

Best Pract Res Clin Rheumatol 2012 Aug;26(4):449-58

Paris Diderot (Paris VII) University, Department of Internal Medicine, Saint-Louis Lariboisière Fernand Widal Hospital Group, Paris, France.

The eosinophilic fasciitis (EF) is a rare connective tissue disease characterized by symmetrical and painful swelling with a progressive induration and thickening of the skin and soft tissues. The diagnosis of EF is often based on the association of characteristic skin or subcutaneous abnormalities and a thickened fascia with an inflammatory infiltration, mostly composed of lymphocytes and eosinophils. A peripheral eosinophilia is frequently present, but is not mandatory for the EF diagnosis. Read More

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August 2012
15 Reads

Environmental- and injury-related epidemic-assistance investigations, 1946-2005.

Am J Epidemiol 2011 Dec;174(11 Suppl):S65-79

Office of Deputy Director for Non-Communicable Diseases, Injury, and Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS F-64, Atlanta, GA 30333, USA.

This paper summarizes environmental investigations (n = 458) conducted during the first 60 years of the epidemic-assistance investigation program at the Centers for Disease Control and Prevention. These investigations were grouped into 10 categories: toxic chemicals (n = 102), indoor air quality and outdoor air toxics (n = 21), new or rare epidemic diseases and unexplained syndromes (n = 29), natural disasters (n = 81), terrorism and unintentional human-made disasters (n = 9), substance use and abuse (n = 13), environmental aspects of infectious disease (n = 132), those affecting neonates and infants (n = 11), violence and injuries (n = 51), and miscellaneous (n = 9). Among the most important or prominent were studies of lead and arsenic toxicity at smelters, mercury in paint and beauty creams, dioxin in waste oil in Missouri, polychlorinated biphenyls and multiple other toxic chemicals, global pesticide poisoning outbreaks, hepatic angiosarcoma among vinyl chloride workers, toxic oil syndrome in Spain, eosinophilia-myalgia syndrome from contaminated L-tryptophan, diethylene glycol poisoning in Haiti, aflatoxicosis in Kenya, Gulf War illness among veterans, impact and needs assessments during natural disasters (e. Read More

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December 2011
6 Reads

Post-epidemic eosinophilia-myalgia syndrome associated with L-tryptophan.

Arthritis Rheum 2011 Nov;63(11):3633-9

Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Eosinophilia-myalgia syndrome (EMS) is characterized by subacute onset of myalgias and peripheral eosinophilia, followed by chronic neuropathy and skin induration. An epidemic of EMS in 1989 was linked to consumption of L-tryptophan that had originated from a single source. Following the ban by the Food and Drug Administration (FDA) on the sale of L-tryptophan, the incidence of EMS declined rapidly. Read More

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November 2011
7 Reads

[Eosinophilia myalgia syndrome (EMS) caused by L-tryptophan product and toxic oil syndrome (TOS) caused by denatured rape-seed oil].

Shokuhin Eiseigaku Zasshi 2009 Dec;50(6):279-91

School of Food and Nutritional Sciences, University of Shizuoka, Suruga-ku, Shizuoka, Japan.

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December 2009
4 Reads

[Skin manifestations of toxic syndrome due to denatured rapeseed oil].

Authors:
E Fonseca

Actas Dermosifiliogr 2009 Dec;100(10):857-60

Servicio de Dermatología, Complejo Hospitalario Universitario de A Coruña, España.

This article offered an extensive description of the clinical and pathological features and time-course of the skin manifestations of toxic syndrome caused by denatured rapeseed oil, also known as toxic oil syndrome. This new condition occurred in Spain in 1981 and was due to the ingestion of rapeseed oil intended for industrial use that had been denatured with anilines and subsequently refined and sold fraudulently as olive oil. In total, 20,000 cases and 400 deaths were reported. Read More

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December 2009
4 Reads

AHR activation by tryptophan--pathogenic hallmark of Th17-mediated inflammation in eosinophilic fasciitis, eosinophilia-myalgia-syndrome and toxic oil syndrome?

Immunol Lett 2010 Feb 24;128(2):154-5. Epub 2009 Nov 24.

The aryl-hydrocarbon-receptor (AHR) is involved as receptor and transcription factor in dioxin toxicity. Recently, its role in Th17-mediated autoimmunity and autoinflammation has been described, yet a disease-associated AHR ligand is still elusive. L-tryptophan and its metabolites are assumed to trigger the autoinflammatory disorders eosinophilic fasciitis, eosinophilia-myalgia-syndrome and toxic oil syndrome. Read More

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February 2010
4 Reads

Immunogenetic risk and protective factors for the development of L-tryptophan-associated eosinophilia-myalgia syndrome and associated symptoms.

Arthritis Rheum 2009 Oct;61(10):1305-11

Ichikawa General Hospital, Tokyo Dental College, Ichikawa, Japan.

Objective: To assess L-tryptophan (LT) dose, age, sex, and immunogenetic markers as possible risk or protective factors for the development of LT-associated eosinophilia-myalgia syndrome (EMS) and related clinical findings.

Methods: HLA-DRB1 and DQA1 allele typing and Gm/Km phenotyping were performed on a cohort of 94 white subjects with documented LT ingestion and standardized evaluations. Multivariate analyses compared LT dose, age, sex, and alleles among groups of subjects who ingested LT and subsequently developed surveillance criteria for EMS, developed EMS or characteristic features of EMS (EMS spectrum disorder), or developed no features of EMS (unaffected). Read More

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October 2009
5 Reads

Food contamination.

Dis Mon 2009 May;55(5):263-91

Department of Adolescent Medicine, Childrens Hospital Los Angeles, Los Angeles, California, USA.

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May 2009
5 Reads

Neuromuscular disorders associated with apical hypertrophic cardiomyopathy.

Acta Cardiol 2009 Feb;64(1):85-9

Krankenanstalt Rudolfstiftung, Vienna, Austria.

Background: Cardiomyopathy is a frequent manifestation of neuromuscular disorders.

Aims And Objectives: The aim of this study was to investigate how often apical hypertrophic cardiomyopathy (AHC) is associated with neuromuscular disorders (NMDs), which types of NMDs are associated with AHC, and if the outcome of patients with NMD and AHC is different from those with AHC but without a NMD.

Method: Literature review by means of a Medline (PubMed) search for the terms AHC, apical hypertrophy, NMD, myopathy, muscular dystrophy, skeletal muscle, and cardiac involvement. Read More

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February 2009
5 Reads

[Shulman's syndrome (eosinophilic fasciitis)].

Hautarzt 2009 Apr;60(4):278-81

Hautklinik, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225 Düsseldorf.

Eosinophilic fasciitis is a rare disease characterized by edema, painful indurations, and progressive muscle weakness. Mainly the extremities are involved. We report on a 22-year-old woman with eosinophilic fasciitis presenting with progressive muscle weakness of both hands and feet and a reduced general condition. Read More

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April 2009
4 Reads

Eosinophilic myositis in calpainopathy: could immunosuppression of the eosinophilic myositis alter the early natural course of the dystrophic disease?

Neuromuscul Disord 2009 Apr 13;19(4):261-3. Epub 2009 Mar 13.

Department of Neurology, Neuromuscular Unit, Istanbul University, Istanbul Medical Faculty, Capa, Istanbul 34390, Turkey.

An 11-year-old girl with a calpain-3 gene (CAPN-3) mutation and eosinophilic myositis on muscle biopsy had high serum CK levels and eosinophil counts which showed spontaneous fluctuations. After commencement of immunosuppressive therapy reciprocal changes occurred in response to alterations in doses of the medications. Subacutely evolving and spreading muscle weakness developed during tapering of the immunosuppressive medications. Read More

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April 2009
9 Reads

Review article toxic oil syndrome: review of immune aspects of the disease.

J Immunotoxicol 2005 Jan;2(1):51-8

Laboratory of Molecular Toxicology, Environmental Toxicology Program, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, North Carolina.

In 1981-1982, individuals in fourteen central and northwest provinces in Spain were affected by an illness that was eventually labeled toxic oil syndrome (TOS) by the World Health Organization. Thousands of individuals were diagnosed with, and 356 people eventually died from, the disease. The disease shares striking similarities with several autoimmune diseases, particularly eosinophilia-myalgia syndrome (EMS) and diffuse fasciitis with eosinophilia (DFE). Read More

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January 2005
5 Reads

[Current differential diagnosis of hypereosinophilic syndrome].

Med Pregl 2007 Nov-Dec;60(11-12):581-6

Klinika za hematologiju, Klinicki centar Vojvodine, Novi Sad.

Introduction: Hypereosinophilic syndrome (HES) is a group of idiopathic disorders associated with single or multiple organ system dysfunction. HES must be distinguished from reactive eosinophilia in parasitic infections, allergic diseases, and especially from hematological diseases of clonal origin.

Reactive Eosinophilia Due To Infectious And Parasitic Diseases: Tissue helminth infections, especially toxocariasis, cause severe and long-standing hypereosinophilia. Read More

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September 2008
8 Reads

Activity of certain drugs in inducing of inflammatory myopathies with cutaneous manifestations.

Expert Opin Drug Saf 2008 Jul;7(4):421-33

University of Medicine, Department of Dermatology and Venereology, 1 St Georgi Sofiiski Street, 1431 Sofia, Bulgaria.

Background: At present, the pharmacological activity of drugs in inducing of inflammatory myopathies is not a solved problem.

Objective: Analysis of the adverse reaction of drugs show that in both adults and children they can cause clinical manifestations of dermatomyositis and its variants [classic, juvenile, paraneoplastic or amyopathic], polymyositis and its variants [eosinophilic myositis, overalp syndrome], or other conditions such as eosinophilia myalgia syndrome, and eosinophilic fasciitis.

Methods: Literature databases were analyzed and combined with personal experience to identify drug activity associated with dermatomyositis and its variants. Read More

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July 2008
6 Reads

Scleroderma-like disorders.

Autoimmun Rev 2008 Feb 11;7(4):331-9. Epub 2008 Jan 11.

Rheumatology Unit, Azienda Ospedaliera Universitaria V. Emanuele, Ferrarotto, S. Bambino Catania, Italy.

Fibrosing disorders comprise a wide spectrum of heterogeneous diseases characterized by sclerosis of the dermis, subcutis, and sometimes the underlying soft tissues and bone. The hallmark of this group of diseases is skin thickening as in systemic sclerosis with a different distribution pattern and for this reason they have also been referred to as "scleroderma-like" disorders. These diseases may have a different clinical course ranging from a benign disease with a localized cutaneous involvement, to a widespread, systemic, life-threatening disease. Read More

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February 2008
6 Reads

[Acute respiratory failure as a manifestation of eosinophilia-myalgia syndrome associated with L-tryptophan intake].

J Bras Pneumol 2007 Nov-Dec;33(6):747-51

Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.

Eosinophilia-myalgia syndrome was described in 1989 in patients who presented progressive and incapacitating myalgia and eosinophilia in blood, fluids and secretions. Most patients report previous L-tryptophan intake. Respiratory manifestations are found in up to 80% of the cases, occasionally as the only manifestation. Read More

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July 2008
7 Reads

Generation of quinoneimine intermediates in the bioactivation of 3-(N-phenylamino)alanine (PAA) by human liver microsomes: a potential link between eosinophilia-myalgia syndrome and toxic oil syndrome.

Chem Res Toxicol 2007 Oct 25;20(10):1556-62. Epub 2007 Sep 25.

Department of Biological Organic Chemistry, Institut d'Investigacions Químiques i Ambientals de Barcelona, Spain.

Eosinophilia-myalgia syndrome (EMS) was an intoxication episode that occurred in the US in 1989 and affected 1,500 people. EMS was associated with the ingestion of manufactured L-tryptophan, and 3-(N-phenylamino)alanine (PAA) was identified as one of the contaminants present in the L-tryptophan batches responsible for intoxication. In previous studies (Martínez-Cabot et al. Read More

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October 2007
6 Reads

Part II. Eosinophilia-Myalgia Syndrome: further correlations between compromised histamine degradation, eosinophilias and myopathies.

Inflamm Res 2007 Apr;56 Suppl 1:S7-8

Division of Natural Products, Center for Food Safety and Applied Nutrition, Food and Drug Administration, 5100 Paint Branch Parkway, College Park, Maryland 20740-3835, USA.

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April 2007
5 Reads

Strain-dependent acute lung injury after intra-tracheal administration of a 'refined' aniline-denatured rapeseed oil: a murine model of the toxic oil syndrome?

Food Chem Toxicol 2007 Dec 4;45(12):2563-73. Epub 2007 Jul 4.

Laboratory of Lung Toxicology, K.U. Leuven, Leuven, Belgium.

Most attempts to reproduce the toxic oil syndrome in animals, either with case-related oils or with refined rapeseed oils, have been unsuccessful. An aniline-denatured rapeseed oil that was subsequently refined according to a protocol yielding relevant markers of "toxic oil" (oil RSO160401) had led to possibly relevant lesions following oral administration in mice. Therefore, in the present study, RSO160401 was subjected to a more extended in vivo testing. Read More

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December 2007
5 Reads

[Diagnostic problems in eosinophilic fasciitis].

Pol Arch Med Wewn 2006 Aug;116(2):777-80

Katedra i Klinika Reumatologiczno-Rehabilitacyjna i Chorób Wewnetrznych AM.

We presented two cases with symptoms of diffuse swelling of subcutaneous tissue, stiffness and tenderness of involved areas, fever, eosinophilia and hypergammaglobulinemia. The inflammatory infiltrates consisting of lymphocytes, plasma cells and eosinophils were yielded in fascia. The difficulties in differentition of the symptoms between eosinophilic fasciitis and "eosinophilia-myalgia syndrome" are discussed. Read More

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August 2006
23 Reads

Calcinosis cutis in a patient with eosinophilia-myalgia syndrome: case report.

Cutis 2006 Jun;77(6):361-4

Department of Dermatology, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA.

Eosinophilia-myalgia syndrome (EMS) often is a disabling disorder caused by the consumption of contaminated L-tryptophan. Affected patients present with an array of symptoms, including cutaneous manifestations, peripheral eosinophilia, myalgias, and long-term neurocognitive disability. This article is the first reported case of a patient with EMS who developed calcinosis cutis. Read More

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June 2006
3 Reads

Is the L-tryptophan metabolite quinolinic acid responsible for eosinophilic fasciitis?

Clin Exp Med 2006 Jun;6(2):60-4

Qld Skin and Cancer Foundation, Greenslopes Private Hospital, Newdegate St, Greenslopes 4120, Qld, Australia.

The eosinophilia-myalgia syndrome is accompanied by alterations in L-tryptophan metabolism with elevated levels of L-kynurenine and quinolinic acid having been recorded. It has been suggested that this is due to activation of indoleamine 2,3-dioxygenase by interferon-gamma. It is unknown whether these products of tryptophan metabolism play a role in the pathogenesis of this syndrome and the closely related condition of eosinophilic fasciitis. Read More

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June 2006
1 Read

Drug-, toxin-, and radiation therapy-induced eosinophilic pneumonia.

Semin Respir Crit Care Med 2006 Apr;27(2):192-7

Department of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.

A significant number of drugs and toxins have been associated with eosinophilic pneumonia. Antibiotics and NSAID, are the most commonly reported drugs. Toxins suspected to cause eosinophilic pneumonia include cigarette smoke and illicit drugs. Read More

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April 2006
1 Read

[Application of multi-slice spiral CT in the diagnosis of pulmonary hypertension].

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2006 Feb;28(1):44-8

Department of Radiology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.

Objective: To evaluate the utility of multi-slice spiral CT in the diagnosis of pulmonary hypertension.

Methods: The clinical and multi-slice spiral CT data of 22 patients with pulmonary hypertension were retrospectively analyzed. The diagnoses included chronic thromboembolic pulmonary hypertension (CTEPH) (n = 9), primary pulmonary hypertension (PPH) (n = 7), connective tissue diseases (n = 2), portal-pulmonary hypertension (n = 2), eosinophilia-myalgia syndrome (n = 1), and fibrosing mediastinitis (n = 1). Read More

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February 2006
4 Reads

Does 5-hydroxytryptophan cause acute and chronic toxic perturbations in rats?

Toxicol Mech Methods 2006 ;16(5):281-6

Department of Physiology and Biophysics, Georgetown University Medical Center, Washington, DC.

In 1989, an epidemic of eosinophilia-myalgia syndrome (EMS) occurred in the United States that was attributed to contaminated l-tryptophan (LT). Features of tryptophan-induced EMS included debilitating myalgia and marked peripheral eosinophilia. Although the contaminant(s) was found only in the product produced by a single manufacturer (Showa Denko), all LT was withdrawn from the market and replaced by 5 hydroxytryptophan (5HTP). Read More

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October 2012
1 Read

A heretofore undisclosed crux of eosinophilia-myalgia syndrome: compromised histamine degradation.

Inflamm Res 2005 Nov;54(11):435-50

Division of Natural Products, Center for Food Safety and Applied Nutrition, Food and Drug Administration, 5100 Paint Branch Parkway, College Park, Maryland 20740-3835, USA.

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. Read More

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November 2005
1 Read

Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophan.

Pharmacol Ther 2006 Mar 14;109(3):325-38. Epub 2005 Jul 14.

Mood Disorders Center, Portland VA Medical Center, Portland, OR 97239, USA.

This paper reviews the preclinical and clinical evidence regarding the use of the dietary supplement 5-hydroxytryptophan (5-HTP) for the treatment of depression. In the absence of supplementation with exogenous 5-HTP, the amount of endogenous 5-HTP available for serotonin synthesis depends on the availability of tryptophan and on the activity of various enzymes, especially tryptophan hydroxylase, indoleamine 2,3-dioxygenase, and tryptophan 2,3-dioxygenase (TDO). Factors affecting each of these are reviewed. Read More

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March 2006
56 Reads

Eosinophilic perimyositis as the presenting feature of a monoclonal T-cell expansion.

Muscle Nerve 2005 May;31(5):646-51

Neurology Service, CHU Vaudois, Room BH07/306, 1011 Lausanne, Switzerland.

A 51-year-old physically active man was investigated for exertional myalgias and muscle stiffness. On examination he had mild proximal muscle weakness of the upper extremities and retraction of the digit flexors. Blood eosinophilia was present, but serum creatine kinase (CK) levels and an electromyographic study were normal. Read More

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May 2005
5 Reads

Miliary tuberculosis in a patient with eosinophilic fasciitis.

South Med J 2005 Jan;98(1):107-10

Department of Medicine, Divisions of Infectious Disease and Dermatology, General Hospital of Castellon, Castellon, Spain.

The fibrosing disorders represent a diverse group of uncommon chronic diseases that include systemic sclerosis, eosinophilic fasciitis, eosinophilia-myalgia syndrome, toxic oil syndrome, and localized forms of fibrosis. A rare case of eosinophilic fasciitis is reported. The patient was a 61-year-old female who presented with generalized massive edema and eosinophilia. Read More

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January 2005
2 Reads

Safety of 5-hydroxy-L-tryptophan.

Toxicol Lett 2004 Apr;150(1):111-22

ISSI Laboratories Inc., 515 Blue Ridge Avenue, Piscataway, NJ 08854, USA.

5-Hydroxy-L-tryptophan (5-HTP) is the immediate precursor in the biosynthesis of 5-hydroxy-tryptamine (5-HT; serotonin) from the essential amino acid L-tryptophan (L-Trp). The use of L-Trp as a dietary supplement was discontinued in 1989 due to an outbreak of eosinophilia-myalgia syndrome (EMS) that was traced to a contaminated synthetic L-Trp from a single manufacturer. 5-HTP has since become a popular dietary supplement in lieu of the removal of L-Trp from the market. Read More

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Pulmonary hypertension as a result of drug therapy.

Clin Chest Med 2004 Mar;25(1):123-31

Division of Clinical Science (South), Medical School, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2RX, UK.

Pulmonary hypertension, as a result of adverse drug reactions, must be considered as a rare occurrence. With good medicinal chemistry and screening of compounds before entry into man, it should be almost totally avoidable. Life and medicine are a continuing challenge as our exploration of the regions of unknown biology throw up new targets and new mechanisms and may catch us again as the anorectic (anorectic) drug caught our predecessors. Read More

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March 2004
3 Reads
2.070 Impact Factor

Drug-induced eosinophilic lung disease.

Authors:
James N Allen

Clin Chest Med 2004 Mar;25(1):77-88

Division of Pulmonary and Critical Care Medicine, The Ohio State University, 201 Heart Lung Institute Building, 473 West 12th Avenue, Columbus, OH 43210, USA.

For most patients who have suspected drug-induced eosinophilic lung disease, the history provides a presumptive diagnosis that can be confirmed by pulmonary findings and eosinophilia after cessation of the drug. As new drugs are developed and released for clinical use, many will result in eosinophilic lung disease in susceptible patients. Therefore, development of pulmonary abnormalities in conjunction with blood or lung eosinophilia after prescription ofa newly released medication should raise the possibility of drug-induced lung disease, even if that medication has not yet been reported to cause eosinophilic lung disease. Read More

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March 2004
2 Reads

[Diagnostic performance of echocardiography in the follow-up of patients with toxic oil syndrome].

Rev Esp Cardiol 2003 Dec;56(12):1195-201

Centro de Investigación Clínica para el Síndrome del Aceite Tóxico y Enfermedades Raras (CISATER). Hospital Carlos III. Instituto de Salud Carlos III. Madrid. Spain.

Introduction And Objectives: Toxic oil syndrome is an epidemic, multisystemic disease that appeared in Spain in 1981, and was caused by the consumption of rapeseed oil denatured with 2% aniline. The disease is similar to eosinophilia-myalgia syndrome. One of the cardiovascular disorders caused by this syndrome is pulmonary hypertension. Read More

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December 2003
1 Read

Toxic oil syndrome: survival in the whole cohort between 1981 and 1995.

J Clin Epidemiol 2003 Jul;56(7):701-8

Centro de Investigación sobre el Síndrome del Aceite Tóxico y Enfermedades Raras, Instituto de Salud Carlos III, C/ Sinesio Delgado, 6 28029 Madrid, Spain.

Background And Objective: In 1981, toxic oil syndrome (TOS) appeared in Spain, affecting more than 20,000 persons and causing over 2500 deaths to date. Previous studies have addressed mortality only by gender and age. We analyzed possible prognostic factors in the survival of the cohort. Read More

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July 2003
2 Reads

Non-L-tryptophan related eosinophilia-myalgia syndrome with hypoproteinemia and hypoalbuminemia.

Authors:
Leon Margolin

J Rheumatol 2003 Mar;30(3):628-9

Department of Medicine, Rabin Medical Center, Petah Tiqva, Israel.

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March 2003
4 Reads

Structural characterization of a case-implicated contaminant, "Peak X," in commercial preparations of 5-hydroxytryptophan.

J Rheumatol 2003 Jan;30(1):89-95

Biomedical Mass Spectrometry and Functional Proteomics Facility, Mayo Clinic, Rochester, Minnesota, USA.

Objective: To determine the chemical structure of a contaminant, X1, previously found in eosinophilia myalgia syndrome case-implicated 5-hydroxytryptophan (5-OHTrp), and also present in over-the-counter (OTC) commercially available 5-OHTrp.

Methods: Case-implicated 5-OHTrp as well as 6 OTC samples were subjected to accurate mass HPLC-mass spectrometry and HPLC-electrochemical detection, and reacted with reduced glutathione. Peak X1 was subsequently subjected to HPLC-tandem mass spectrometry (MS/MS), as well as the resulting nucleophilic glutathione product. Read More

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January 2003
17 Reads

Toxic oil syndrome: the perspective after 20 years.

Epidemiol Rev 2001 ;23(2):231-47

Centro de Investigación sobre el Síndrome del Aceite Tóxico, Instituto de Salud Carlos III, Madrid, Spain.

Toxic oil syndrome burst upon the scene in Spain in May of 1981, draining the resources of a newly evolving political and social medicine system. The vehicle of the causative toxic agent was identified as an illicit oil that had been diverted from industrial use and refined in order to remove the aniline denaturant, and that was sold in unlabeled 5-liter containers by itinerant salesmen. Over 20,000 people were ultimately affected, and over 1,200 deaths from all causes have been recorded in the affected cohort. Read More

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October 2002
2 Reads

Panniculitis.

Dermatol Clin 2002 Jul;20(3):421-33, vi

Department of Dermatology, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 623, PO Box 250618, Charleston, SC 29425, USA.

The classification of inflammatory disorders of the subcutaneous tissue has mystified dermatologists for decades. Overlapping clinical and histologic features, and a lack of specific treatments have added to the confusion. This article initially classifies the various panniculititides by their primary histopathologic pattern: (1) septal panniculitis without vasculitis, (2) septal panniculitis with vasculitis, (3) lobular panniculitis without vasculitis, and (4) lobular panniculitis with vasculitis. Read More

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July 2002
2 Reads