Glickstein S L, Gertner E, Smith S A, Roelofs R I, Hathaway D E, Schlesinger P A, Schned E S
Section of Rheumatology and Neurology, University of Minnesota Medical School, Minneapolis.
J Rheumatol. 1990 Nov;17(11):1534-43.
The eosinophilia-myalgia syndrome associated with the use of oral preparations of the amino acid L-tryptophan was recognized in late 1989. We describe the clinical and laboratory manifestations, pathological findings and early clinical course of 20 patients with the eosinophilia-myalgia syndrome. Prominent clinical findings included severe myalgias limiting function, fatigue, rashes, edema and weight gain, weight loss, muscle weakness and shortness of breath. Laboratory findings included eosinophilia (often marked), normal erythrocyte sedimentation rate, and elevated aldolase with normal or low creatine kinase values. On biopsy fascial inflammation was always seen consisting of lymphocytes, histiocytes and eosinophils in a perivascular distribution. Invasion of the vascular wall by lymphocytes was seen in 20%. Capillary and arteriolar endothelial cell thickening was found in most cases on electron microscopy and endothelial cell necrosis or mural invasion by lymphocytes was seen in 25% of cases. Two patients improved with no therapy. Ten patients responded to therapy with prednisone alone. Three patients have had progressive disease and one of these died. The relationship of this syndrome to previously described disease entities associated with eosinophilia is discussed.
与使用氨基酸L-色氨酸口服制剂相关的嗜酸性粒细胞增多性肌痛综合征于1989年末被确认。我们描述了20例嗜酸性粒细胞增多性肌痛综合征患者的临床和实验室表现、病理结果及早期临床病程。突出的临床表现包括严重肌痛导致功能受限、疲劳、皮疹、水肿、体重增加、体重减轻、肌肉无力和呼吸急促。实验室检查结果包括嗜酸性粒细胞增多（常很明显）、红细胞沉降率正常、醛缩酶升高而肌酸激酶值正常或降低。活检时总是可见筋膜炎症，由淋巴细胞、组织细胞和嗜酸性粒细胞呈血管周围分布组成。20%的病例可见淋巴细胞侵入血管壁。多数病例在电子显微镜下发现毛细血管和小动脉内皮细胞增厚，25%的病例可见内皮细胞坏死或淋巴细胞壁内浸润。2例患者未经治疗而病情改善。10例患者单独使用泼尼松治疗有效。3例患者病情进展，其中1例死亡。本文讨论了该综合征与先前描述的与嗜酸性粒细胞增多相关的疾病实体之间的关系。
