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Millicent Eidson, MA, DVM
New Mexico Health and Environment Department Santa Fe

JAMA. 1990;264(8):970.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Clauw et al¹ speculate that the pathogenesis of eosinophilia-myalgia syndrome may be related to abnormalities in tryptophan metabolism. Current epidemiologic evidence does not support this hypothesis.

Our study,² the first to provide evidence of a causal association between tryptophan-containing products and eosinophilia-myalgia syndrome, ascertained all high eosinophil counts at nine laboratories from May 1, 1989, to October 31, 1989, and found no cases of eosinophilia-myalgia syndrome with onset before July 1989. Of 429 cases reported to the Centers for Disease Control (CDC), Atlanta, Ga, by January 9, 1990, 87% reported symptom onset after July 1989.³ As of March 23, 1990, one thousand four hundred seventeen eosinophilia-myalgia syndrome cases have been reported in the United States, with 20 deaths. Seventy-six cases have been reported from other countries (CDC, Update Briefing, March 23, 1990). Since manufactured tryptophan has been consumed worldwide for years, problems with tryptophan metabolism . . . [Full Text PDF of this Article]

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