Slutsker L, Hoesly F C, Miller L, Williams L P, Watson J C, Fleming D W
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, Atlanta, Ga. 30333.
JAMA. 1990 Jul 11;264(2):213-7.
Although eosinophilia-myalgia syndrome has been linked to use of tryptophan, it has been unclear whether tryptophan itself or a contaminant causes illness. In Oregon, we compared the brand and source of tryptophan used by 58 patients with eosinophilia-myalgia syndrome with the brand and source of tryptophan used by 30 asymptomatic controls identified through a random telephone survey and 63 asymptomatic controls who contacted the Oregon Health Division voluntarily. Although a single brand/retail lot of tryptophan was statistically associated with the development of eosinophilia-myalgia syndrome, there was no common importer, wholesaler, tablet maker, encapsulator, or distributor. However, 45 (98%) of 46 cases had taken a product made by one manufacturer, compared with three (30%) of 10 telephone survey controls and 15 (48%) of 31 volunteer controls. Retail lots of tryptophan from this manufacturer that were associated with cases were significantly more likely to have been produced from January through June 1989 than lots from this manufacturer that were taken by controls. These findings indicate that the recent epidemic of eosinophilia-myalgia syndrome was caused by a contaminant or an alteration in a subset of tryptophan manufactured by a single company in Japan shortly before the outbreak began.
虽然嗜酸性粒细胞增多性肌痛综合征与色氨酸的使用有关，但尚不清楚是色氨酸本身还是一种污染物导致了疾病。在俄勒冈州，我们将58例嗜酸性粒细胞增多性肌痛综合征患者所使用色氨酸的品牌和来源，与通过随机电话调查确定的30名无症状对照者以及63名自愿联系俄勒冈州卫生部门的无症状对照者所使用色氨酸的品牌和来源进行了比较。虽然单一品牌/零售批次的色氨酸与嗜酸性粒细胞增多性肌痛综合征的发生在统计学上相关，但没有共同的进口商、批发商、片剂制造商、胶囊填充商或经销商。然而，46例病例中有45例（98%）服用了一家制造商生产的产品，相比之下，10名电话调查对照者中有3例（30%），31名自愿对照者中有15例（48%）。与病例相关的该制造商的色氨酸零售批次，比对照者所服用的该制造商的批次更有可能是在1989年1月至6月生产的。这些发现表明，近期嗜酸性粒细胞增多性肌痛综合征的流行是由日本一家公司在疫情爆发前不久生产的一部分色氨酸中的污染物或改变所引起的。
