Smith S A
University of Minnesota, Hennepin Faculty Associates Neuromuscular Center, Minneapolis 55404, USA.
Adv Exp Med Biol. 1996;398:359-64. doi: 10.1007/978-1-4613-0381-7_55.
Acute eosinophilia-myalgia syndrome (EMS) due to contaminated L-tryptophan (LT) exposure is an inflammatory microangiopathy of the dermis, fascia, and muscle. Select individuals evolve from acute EMS to have persistence of myalgia, fatigue, cramps, and skin changes for years. Many develop memory dysfunction and confusion. The objective of this study is to delineate the pathology in individuals with chronic EMS. Seventeen patients with ongoing symptoms representing chronic EMS are studied by skin, fascia, and muscle biopsies four to five years after exposure to contaminated LT and initial onset of EMS. All have microvascular disease. Most have lymphocytic inflammatory infiltrates. Several have dermal sclerosis. The findings indicate that persistent microvascular disease is present in chronic EMS. The pathologic changes are similar to those of acute EMS but with notable differences. Tissue eosinophil infiltration is rare in the chronic state as compared to acute EMS. The persistence of endothelial pathology indicates continuing microvascular dysfunction.
因接触受污染的L-色氨酸（LT）而导致的急性嗜酸性粒细胞增多性肌痛综合征（EMS）是一种真皮、筋膜和肌肉的炎症性微血管病。部分患者会从急性EMS发展为多年来持续存在肌痛、疲劳、痉挛和皮肤改变。许多患者会出现记忆功能障碍和意识模糊。本研究的目的是明确慢性EMS患者的病理学特征。对17例有持续症状、代表慢性EMS的患者，在接触受污染的LT并初次发病EMS四至五年后进行皮肤、筋膜和肌肉活检。所有患者均有微血管疾病。大多数患者有淋巴细胞炎性浸润。有几例患者出现真皮硬化。研究结果表明，慢性EMS存在持续性微血管疾病。病理变化与急性EMS相似，但有显著差异。与急性EMS相比，慢性状态下组织嗜酸性粒细胞浸润很少见。内皮病理的持续存在表明微血管功能持续障碍。
