Talpos D C, Carstens S A, Silverman J, Gladson C L
Departments of Neurology, University of California San Diego Medical Center.
Am J Surg Pathol. 1991 Mar;15(3):222-6. doi: 10.1097/00000478-199103000-00002.
Skeletal muscle biopsies from five patients with severe myalgias, peripheral eosinophilia, and a recent history of L-tryptophan ingestion were analyzed. Perimysial inflammation, predominantly mononuclear with variable numbers of eosinophils was seen (in five of five patients), which was perineurial (in three of five) and perivascular (in five of five) in location. Grouping of the myofiber types was identified by enzyme histochemistry in two of four patients; fresh muscle for histochemical studies was unavailable from one patient. An occasional degenerating myofiber was seen in only one patient, who was still ingesting L-tryptophan at the time of biopsy. No vasculitis was seen. The focus of muscle injury in this syndrome appeared to be the perimysium and, in particular, the perineurial and perivascular connective tissue.
对五名患有严重肌痛、外周嗜酸性粒细胞增多且近期有L-色氨酸摄入史的患者的骨骼肌活检样本进行了分析。可见肌束膜炎症，主要为单核细胞炎症，伴有数量不等的嗜酸性粒细胞（五名患者均如此），炎症位于神经束膜周围（五名患者中有三名）和血管周围（五名患者均如此）。通过酶组织化学法在四名患者中的两名中发现了肌纤维类型分组；一名患者无法获得用于组织化学研究的新鲜肌肉。仅在一名患者中偶尔可见变性肌纤维，该患者在活检时仍在摄入L-色氨酸。未发现血管炎。该综合征中肌肉损伤的焦点似乎是肌束膜，尤其是神经束膜和血管周围的结缔组织。
