We report a case of clinical features corresponding to Eosinophilia-Myalgia syndrome, with no causal relationship with L-tryptophan. Since the epidemic of L-tryptophan associated Eosinoghilia-Myalgia Syndrome in 1989, only 2% of the cases were found not to be related to L-tryptophan in America. We believe that this is the first case report of Eosinophilin-Myalgia Syndrome not related to L-tryptophan in Korea.
Americas ; Electrodiagnosis ; Eosinophilia-Myalgia Syndrome* ; Korea ; Tryptophan*

Eosinophilia-myalgia syndrome(EMS) is a systemic illness that occurred as an epidemic by ingestion of over-the counter L-tryptophan preparation in the United States in October 1989. We report a Korean case of EMS not associated with the ingestion of either L-tryptophan or other nutritional supplements such as lysine and niacin.
Eating* ; Eosinophilia-Myalgia Syndrome* ; Lysine ; Niacin ; Tryptophan ; United States

Eosinophilia-myalgia syndrome (EMS) is a multisystemic disorder characterized by severe myalgia and peripheral eosinophilia, and frequently accompanied by fasciitis, neuropathy and various cutaneous manifestations associated with consumption of L-tryptophan. Although EMS has not been uncommon in the United States, it has not been reported in Korea. We experienced a 28-year-old man who presented with severe myalgia, peripheral eosinophilia, right upper extremity motor weakness developed during ingestion of L-tryptophan containing food. He was diagnosed as EMS based on the diagnostic criteria by the Centers for Disease Control. His symptoms and laboratory findings including severe myalgia and eosinophilia rapidly improved after steroid treatment. To our knowledge, this is the first case report of EMS developed in L-tryprophan users in Korea. We report a case of EMS with a review of literature.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Eating ; Eosinophilia ; Eosinophilia-Myalgia Syndrome ; Fasciitis ; Humans ; Korea ; Myalgia ; Tryptophan ; United States ; Upper Extremity

We report a case of Eosinophilia- Myalgia syndrome with central nervous system (CNS) involvement following ingestion of the essential amino acid, tryptophan. The Eosinophilia- Myalgia syndrome can be diagnosed when there is a severe myalgia and peripheral eosinophilia in the absence of other diseases causing eosinophilia. This condition has been associated with the ingestion of the tryptophan in many cases, but the amount and duration of ingestion have been yet to be elucidated. Although many cases have been reported, few cases involved the CNS. We present a 28 year- old male who complained of a severe myalgia and disorientation after taking the taken tryptophan for 2 weeks. Thorough examination revealed the peripheral eosinophilia, vasculitis on brain MRI, abnormal VEP, and muscle atrophy on muscle biopsy. Symptoms improved with the steroid pulse after discontinuation of the tryptophan.
Biopsy ; Brain ; Central Nervous System* ; Eating* ; Eosinophilia ; Eosinophilia-Myalgia Syndrome* ; Humans ; Magnetic Resonance Imaging ; Male ; Muscular Atrophy ; Myalgia ; Tryptophan* ; Vasculitis

We report the case of a 47-year-old female who developed idiopathic eosinophilia-myalgia syndrome following complete remission of non-Hodgkin's lymphoma. She had been diagnosed extranodal marginal zone B cell lymphoma of nasal cavity and treated with CHOP chemotherapy and radiotherapy. She complained fever, myalgia and the complete blood count showed markedly elevated eosinophil count. Non-Hodgkin's lymphoma was confirmed in complete remission state by PNS CT, nasal septum biopsy and bone marrow biopsy. The patient showed eosinophilia in peripheral blood, myositis in electromyography and muscle biopsy consistent with eosinophilia-myalgia syndrome. The symptoms were improved and the eosinophilia count was decreased after prednisolone medication. We report a case of idiopathic eosinophilia-myalgia syndrome with a review of the literature.
Biopsy ; Blood Cell Count ; Bone Marrow ; Drug Therapy ; Electromyography ; Eosinophilia ; Eosinophilia-Myalgia Syndrome* ; Eosinophils ; Female ; Fever ; Humans ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Middle Aged ; Myalgia ; Myositis ; Nasal Cavity ; Nasal Septum ; Prednisolone ; Radiotherapy

Hypereosinophilic syndrome is a rare disease characterized by marked peripheral eosinophilia and eosinophilic infiltration of many organs such as heart, lung, central nervous system, liver and spleen. This disease is defined by following criteria. First, sustained blood eosinophilia is greater than 1,500/mm3 longer than 6 months. Second, other apparent etiologies for eosinophilia must be absent, including parasitic infestation and allergic disease. Third, patients must have signs and symptoms of organ involvement. In Korea, some cases that eosinophil infiltrated lung, liver, gastrointestinal tract or skin were reported. In this report, we found a case showing myalgia, fatigue and eosinophilia in periodic health examination, and diagnosed hypereosinophilic syndrome.
Central Nervous System ; Eosinophilia ; Eosinophils ; Fatigue ; Gastrointestinal Tract ; Heart ; Humans ; Hypereosinophilic Syndrome* ; Korea ; Liver ; Lung ; Myalgia ; Preventive Health Services ; Rare Diseases ; Skin ; Spleen

Eosinophilic infiltration into skeletal muscles has been rarely reported in a variety of conditions such as parasite infection, sarcoidosis, rheumatoid arthritis, eosinophilia-myalgia syndrome, and idiopathic hypereosinophilic syndrome. Eosinophilic myositis (EM) is one of idiopathic inflammatory muscle diseases associated with muscle and/or blood eosiophilia. The case of EM complicated with hypercapnic respiratory failure has been extremely rarely reported. A 61-year-old woman was admitted with sudden-onset pain in both calves. She had elevated serum muscle enzymes and peripheral eosinophil count. Findings of electromyography were consistent with inflammatory myopathy. MRI showed diffuse hyperintensity of calf muscles on T2-weighted and enhanced T1 images. Muscle biopsy showed eosinophils' infiltration in the endomysium and perivascular area. During the diagnostic work-up, she presented with hypercapnic respiratory failure. She was successfully treated with mechanical ventilation and high doses of prednisolone. This case suggests EM can cause respiratory failure secondary to respiratory muscle involvement.
Arthritis, Rheumatoid ; Biopsy ; Electromyography ; Eosinophilia-Myalgia Syndrome ; Eosinophils* ; Female ; Humans ; Hypereosinophilic Syndrome ; Magnetic Resonance Imaging ; Middle Aged ; Muscle, Skeletal ; Muscles ; Myositis ; Parasites ; Polymyositis* ; Prednisolone ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Muscles ; Sarcoidosis