Eosinophilia-myalgia syndrome among the non-L-tryptophan users and pre-epidemic cases.
Eosinophilia-myalgia syndrome (EMS) has been associated with L-tryptophan (LT) use since 1989, but as yet no etiologic agent has been identified.
We describe the non-L-tryptophan associated cases of EMS, and those patients with illness onset preceding the 1989 epidemic.
Review of all patients in the EMS national state based surveillance system administered by the Centers for Disease Control and Prevention (CDC) who satisfied the EMS surveillance case definition.
Of 1345 persons with EMS that satisfied the CDC surveillance case definition for EMS, 26 (2%) persons reported not having used LT (non-LT).
Persons who did not use LT were significantly younger (mean age 39 years ; p=0.02) and were more likely than LT users to have onset of their illness before the EMS epidemic (before July 1,1989) (p<0.001).
Non-LT users reported fewer pulmonary symptoms but had rates of neuropathy and scleroderma-like skin changes similar to LT users.
Non-LT users had lower mean eosinophil counts (5.6 x 109 cells/l ; LT users 6.2 x 109 cells/l), reported no EMS attributable deaths, but were hospitalized (48%) more often than LT users (34%). Of the 1345 EMS cases, 191 (14%) reported a pre-epidemic illness onset.
Symptoms of peripheral edema, rash, scleroderma-like skin change, alopecia, and neuropathy were more prevalent in pre-epidemic patients.
Mean eosinophil count was significantly higher for epidemic patients than for pre-epidemic patients (p=0.004). (...)
Mots-clés Pascal : Eosinophilie, Myalgie, Homme, Epidémiologie, Etats Unis, Amérique du Nord, Amérique, Epidémie, Tryptophane, Etiologie, Registre, Surveillance, Douleur, Aminoacide, Hémopathie, Muscle strié pathologie, Eosinophilie myalgie syndrome
Mots-clés Pascal anglais : Eosinophilia, Myalgia, Human, Epidemiology, United States, North America, America, Epidemic, Tryptophan, Etiology, Register, Surveillance, Pain, Aminoacid, Hemopathy, Striated muscle disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0001997
Code Inist : 002B19D. Création : 21/05/1997.