Criswell L A, Sack K E
Department of Medicine, University of California, School of Medicine, San Francisco.
West J Med. 1990 Sep;153(3):269-74.
Eight patients who became ill while taking tryptophan had myalgia, fatigue, rash, fever, edema, alopecia, arthralgias, diminished joint motion, skin tightening, muscle cramping, and distal paresthesias. Three had shortness of breath, and one had pulmonary hypertension. Laboratory abnormalities included peripheral eosinophilia, leukocytosis, thrombocytosis, raised erythrocyte sedimentation rate, and elevated serum levels of aldolase, lactate dehydrogenase, and liver enzymes. Of 4 chest radiographs, 3 were abnormal. Of 5 skin and muscle biopsies, 4 showed sclerosis or mixed inflammatory cell infiltration of the dermis, subcutis, and fascia. Eosinophils were often present, but vasculitis was absent. Muscle inflammation was minimal. We conclude that the "eosinophilia-myalgia syndrome" is related to the ingestion of tryptophan and that abnormalities in the secretion of lymphokines may be important in its pathogenesis.
8名服用色氨酸期间患病的患者出现了肌痛、疲劳、皮疹、发热、水肿、脱发、关节痛、关节活动受限、皮肤紧绷、肌肉痉挛和远端感觉异常。3人出现呼吸急促，1人患有肺动脉高压。实验室异常包括外周血嗜酸性粒细胞增多、白细胞增多、血小板增多、红细胞沉降率升高以及血清醛缩酶、乳酸脱氢酶和肝酶水平升高。4份胸部X光片中，3份异常。5份皮肤和肌肉活检中，4份显示真皮、皮下组织和筋膜有硬化或混合性炎症细胞浸润。嗜酸性粒细胞常存在，但无血管炎。肌肉炎症轻微。我们得出结论，“嗜酸性粒细胞增多性肌痛综合征”与色氨酸摄入有关，淋巴因子分泌异常可能在其发病机制中起重要作用。
