Herrick M K, Chang Y, Horoupian D S, Lombard C M, Adornato B T
Department of Pathology, Santa Clara Valley Medical Center, San Jose, CA 95128.
Hum Pathol. 1991 Jan;22(1):12-21. doi: 10.1016/0046-8177(91)90055-t.
Pathologic findings in eight patients with the eosinophilia-myalgia syndrome, secondary to L-tryptophan ingestion, are reported. Tissue was obtained by biopsy alone in six patients, by biopsy and autopsy in the seventh patient, and by autopsy alone in the eighth patient. Muscle biopsies in five patients demonstrated an inflammatory infiltrate composed predominantly of lymphocytes, histiocytes, plasma cells, and a few eosinophils. The inflammation involved the perimysial and epimysial connective tissue, the walls of some small blood vessels, the perineurium of small nerve twigs, muscle spindles, and fibrous septae of subcutaneous adipose tissue. In two patients with peripheral neuropathy and one patient without overt neuropathy, denervation atrophy of muscle and perimysial and epimysial fibrosis were present. Sural nerve biopsy tissue taken from two patients displayed prominent axonopathy in one, and minimal changes in the second. Pulmonary changes in the two autopsied patients included endothelial cell damage, endovasculitis and fibromyxoid intimal change im arteries and veins, and interstitial pneumonitis with fibrosis.
报告了8例因摄入L-色氨酸继发嗜酸性粒细胞增多性肌痛综合征患者的病理检查结果。6例患者仅通过活检获取组织，第7例患者通过活检和尸检获取组织，第8例患者仅通过尸检获取组织。5例患者的肌肉活检显示炎症浸润主要由淋巴细胞、组织细胞、浆细胞和少数嗜酸性粒细胞组成。炎症累及肌束膜和肌外膜结缔组织、一些小血管壁、小神经分支的神经束膜、肌梭和皮下脂肪组织的纤维间隔。在2例患有周围神经病变的患者和1例无明显神经病变的患者中，存在肌肉失神经萎缩以及肌束膜和肌外膜纤维化。从2例患者获取的腓肠神经活检组织中，1例显示明显的轴索性病变，另1例显示轻微变化。2例尸检患者的肺部改变包括内皮细胞损伤、动静脉血管内炎症和纤维黏液样内膜改变，以及伴有纤维化的间质性肺炎。
