EOSINOPHILIC HEPATITIS - A NEW FEATURE OF THE CLINICAL SPECTRUM OF THE CLINICAL SPECTRUM OF THE EOSINOPHILIA-MYALGIA-SYNDROME

The eosinophilia-myalgia syndrome associated with L-tryptophan-contain ing products is highlighted by eosinophilia, incapacitating myalgias, and diverse multisystemic manifestations. In addition to involvement o f the skin, skeletal muscle, and peripheral nerves, visceral damage ha s been quite prominent, particularly affecting the lungs, the heart, a nd the liver. Hepatic involvement has been manifested by altered liver tests but is clinically silent. We report the unique case of a woman with this syndrome who developed abdominal pain, a clinical picture of hepatitis and chronically abnormal liver tests. Histologic examinatio n of the liver disclosed eosinophilic hepatitis with piecemeal necrosi s. The occurrence of clinically overt hepatic involvement has not been reported previously. Potential mechanisms of liver damage in eosinoph ilia-myalgia syndromes are discussed.