An eosinophilia-myalgia syndrome related disorder associated with exposure to L-5-hydroxytryptophan
Michelson, D.; Page, S.W.; Casey, R.; Trucksess, M.W.; Love, L.A.; Milstien, S.; Wilson, C.; Massaquoi, S.G.; Crofford, L.J.; Hallett, M.
Journal of Rheumatology 21(12): 2261-2265
1994
ISSN/ISBN: 0315-162X PMID: 7699627 Document Number: 436952
Objective. To determine whether L-5-hydroxytryptophan (L-5-HTP) associated with eosinophiliamyalgia syndrome (EMS) like illness contains impurities in a fashion similar to that described in L-tryptophan associated with EMS. Methods. Members of a family who became ill after exposure to L-5-HTP were evaluated at the National Institutes of Health. Data from patients with extended exposure to L-5-HTP were also examined. Samples of L-5-HTP were examined using high performance liquid chromatography. Results. One member of the family had EMS, and 2 others had eosinophilia. No patient in the other group reviewed developed the syndrome, although 2 patients developed eosinophilia. The L-5-HTP used by the family contained an impurity not present in samples from the other patient group. After replacement with L-5-HTP not containing this impurity, eosinophilia in 2 family members resolved. Conclusion. Some L-5-HTP contains impurities that may be related to L-5-HTP associated EMS.