Kaufman L D
Recenti Prog Med. 1991 May;82(5):286-90.
The recognition of the eosinophilia-myalgia syndrome associated with L-tryptophan in the United States during 1989 as a disorder resembling the previously described 1981 toxic oil syndrome of Spain has established an increased level of consciousness regarding drug and toxin associated diseases. Both of these disorders were characterized by the development of acute and chronic multisystem features that parallel many idiopathic connective tissue diseases. Common manifestations have included generalized myalgias, fever, transient pulmonary infiltrates, and xerostomia during the early months followed by late stage neuromuscular and cutaneous disease. The most conspicuous laboratory abnormality was a peripheral eosinophilia. One of the most striking clinical findings has been scleroderma-like skin disease manifesting as diffuse fasciitis or hidebound induration. A sensory neuropathy and proximal myopathy in association with skin thickening have established these syndromes as chronic disabling diseases for many of their victims. Mononuclear perimysial and epineurial infiltrates have been distinctive pathological findings. Although the etiology of the eosinophilia-myalgia syndrome and the toxic oil syndrome are unknown, there is epidemiologic evidence to support the presence of contaminants in L-tryptophan and rapeseed oil, respectively, as the causative agents. No therapy has been demonstrated to arrest the evolution of the chronic sequelae in either disorder.
1989年在美国，与L - 色氨酸相关的嗜酸性粒细胞增多性肌痛综合征被确认为一种类似于1981年西班牙所描述的有毒油综合征的疾病，这提高了人们对药物和毒素相关疾病的认识水平。这两种疾病都具有急性和慢性多系统特征的发展，与许多特发性结缔组织疾病相似。常见表现包括在最初几个月出现全身肌痛、发热、短暂性肺部浸润和口干，随后出现晚期神经肌肉和皮肤疾病。最明显的实验室异常是外周血嗜酸性粒细胞增多。最显著的临床发现之一是硬皮病样皮肤病，表现为弥漫性筋膜炎或皮肤紧绷硬结。感觉神经病变和近端肌病伴皮肤增厚使这些综合征成为许多受害者的慢性致残性疾病。单核细胞性肌束膜和神经外膜浸润是其独特的病理发现。虽然嗜酸性粒细胞增多性肌痛综合征和有毒油综合征的病因尚不清楚，但有流行病学证据分别支持L - 色氨酸和菜籽油中存在污染物作为致病因素。尚未证明有任何疗法能阻止这两种疾病慢性后遗症的发展。
