AN EOSINOPHILIA-MYALGIA-SYNDROME RELATED DISORDER ASSOCIATED WITH EXPOSURE TO L-5-HYDROXYTRYPTOPHAN

Objective. To determine whether L-5-hydroxytryptophan (L-5-HTP) associ ated with eosinophilia-myalgia syndrome (EMS) like illness contains im purities in a fashion similar to that described in L-tryptophan associ ated with EMS. Methods. Members of a family who became ill after expos ure to L-5-HTP were evaluated at the National Institutes of Health. Da ta from patients with extended exposure to L-5-HTP were also examined. Samples of L-5-HTP were examined using high performance liquid chroma tography. Results. One member of the family had EMS, and 2 others had eosinophilia. No patient in the other group reviewed developed the syn drome, although 2 patients developed eosinophilia. The L-5-HTP used by the family contained an impurity not present in samples from the othe r patient group. After replacement with L-5-HTP not containing this im purity, eosinophilia in 2 family members resolved.Conclusion. Some L-5 -HTP contains impurities that may be related to L-5-HTP associated EMS .