Gordon M L, Lebwohl M G, Phelps R G, Cohen S R, Fleischmajer R
Department of Dermatology, Mount Sinai Medical Center, New York, NY 10029.
Arch Dermatol. 1991 Feb;127(2):217-20.
Recently, the ingestion of tryptophan has been associated with eosinophilia-myalgia syndrome, which is characterized by eosinophilia, myalgias, and several less consistently reported findings. We treated 13 patients who exhibited clinical features of eosinophilic fasciitis who were taking high-dose tryptophan before the onset of clinical symptoms. Twelve patients exhibited eosinophilia, with eosinophil counts ranging from 0.13 to 0.88. The remaining patient was taking oral corticosteroids when her eosinophil count was determined. Eight patients complained of myalgias. Other symptoms included arthralgias, pruritus, cutaneous burning, weakness, fever, rashes, malaise, edema, muscle spasms, and alopecia. 5-Hydroxyindoleacetic acid levels were elevated in four of the eight urine specimens that were tested. Our findings suggest that previously diagnosed cases of eosinophilic fasciitis may represent variants of tryptophan-associated eosinophilia-myalgia syndrome. Derangements in the metabolism of tryptophan may play a role in sclerotic diseases.
最近，色氨酸的摄入与嗜酸性粒细胞增多性肌痛综合征有关，其特征为嗜酸性粒细胞增多、肌痛以及其他一些报道不太一致的表现。我们对13例在临床症状出现前服用高剂量色氨酸且表现出嗜酸性筋膜炎临床特征的患者进行了治疗。12例患者出现嗜酸性粒细胞增多，嗜酸性粒细胞计数范围为0.13至0.88。其余1例患者在测定嗜酸性粒细胞计数时正在服用口服糖皮质激素。8例患者主诉肌痛。其他症状包括关节痛、瘙痒、皮肤烧灼感、虚弱、发热、皮疹、不适、水肿、肌肉痉挛和脱发。在检测的8份尿液标本中，有4份的5-羟吲哚乙酸水平升高。我们的研究结果表明，先前诊断的嗜酸性筋膜炎病例可能代表色氨酸相关嗜酸性粒细胞增多性肌痛综合征的变体。色氨酸代谢紊乱可能在硬化性疾病中起作用。
