Eosinophilia-myalgia syndrome induced by excessive L-tryptophan intake from cashew nuts

• Autorzy: Marko Barešić , Dubravka Bosnić , Marija Bakula , Kamelija Žarković
• Języki publikacji: EN

Abstrakty

EN

Eosinophilia is characterized by more than 0.5 x 109 eosinophils per liter in the full blood count. A wide range of conditions, from asthma to parasitic infections, autoimmune diseases, and certain forms of cancer, have been known to trigger abnormally high amount of eosinophils. It is essential to reach the correct diagnosis and treat the underlying disease aggresively. Definition of the eosinophilia-myalgia syndrome was offered in 1980s by Centers for Disease Control and Prevention for surveillance purposes, and criteria were revised in 2001, with high specificity. We report a case of 59-year old female who started a special weight-reducing diet regimen that included excessive cashew nut ingestion. Several months after she has presented with periferal blood eosinophilia and constitutional symptoms. Detailed work-up has not found elements for haematological, systemic autoimmune, neoplastic or infectious disease. She was diagnosed with eosinophilia- myalgia syndrome due to extreme L-tryptophan intake, a compound found in the cashew nut’s oil. She responded well to cashew nut withdrawal and steroid therapy. In the follow-up period she remained stable with normal eosinophil count and there was not a need for any specific therapy

Słowa kluczowe

EN

Hypereosinophilic syndrome; Eosinophiliamyalgiasyndrome; L-tryptophan; Cashew nuts

• Czasopismo: Open Medicine
• Rocznik: 2014
• Tom: 10
• Numer: 1

Daty

online

2014-11-11

Twórcy

autor

Marko Barešić

• Division of Clinical Immunology
  and Rheumatology, Department of Internal Medicine, School of
  Medicine, University Hospital Center Zagreb, Kišpatićeva 12, 10000
  Zagreb, Croatia

autor

Dubravka Bosnić

• Division of Clinical Immunology
  and Rheumatology, Department of Internal Medicine, School of
  Medicine, University Hospital Center Zagreb, Kišpatićeva 12, 10000
  Zagreb, Croatia

autor

Marija Bakula

• Division of Clinical Immunology
  and Rheumatology, Department of Internal Medicine, School of
  Medicine, University Hospital Center Zagreb, Kišpatićeva 12, 10000
  Zagreb, Croatia

autor

Kamelija Žarković

• Department of Neuropathology, University Hospital
  Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia

Bibliografia

• [1] Holland SM, Gallin JI. Disorders of Granulocytes andMonocytes. In: Fauci AS et al. [ed.] Harrison’s Principles ofInternal Medicine, ed. 17. New York, McGraw-Hill Companies,2008:383
• [2] Medsger, T.A. Eosinophilia-myalgia syndrome. In MedscapeReference [online]. Available at: www.emedicine.medscape.com/article/329614-overview
• [3] Gotlib J. Eosinophilic disorders: Molecular pathogenesis, newclassification and mofern therapy. Best practice & ReasearchClinical Haematology. 2006;19(3):535-569
• [4] Allen J.A., Paterson A., Sufit R., et al. Post-epidemiceosinophilia-myalgia syndrome associated with L-tryptopan.Arthritis & Rheumatism. 2011; 63 (11) 3633-3639
• [5] de Araujo Guerra Grangeia T, Schweller M, Aparecida PaschoalI, et al. Acute respiratory failure as a manifestation ofeosinophilia-myalgia syndrome associated with L-tryptophanintake. J Bras Pulmol. 2007;33(6):747-751
• [6] Noakes R, Spelman L, Williamsom R. Is the L-tryptophanmetabolite quinolonic acid responsable for eosinophilicfasciitis? Clin Exp Med. 2006; 6:60-64[Crossref]
• [7] Hertzman PA, Clauw DJ, Duffy J. Rigorous new approach toconstructing a gold standard for validating new diagnosticcriteria, as exemplified by eosinohilia-myalgia syndrome. AnnIntern Med. 2001; 161: 2301-2306
• [8] Dinic-Uzurov V, Lalosevic V, Milosevic I, et al. [Currentdifferential diagnosis of hypereosinophilic syndrome] MedPregl. 2007:LX (11-12):581-586[Crossref]
• [9] Petterson R, Germolec D. Toxic Oli Syndrome: Review ofimmune aspects of the disease. J of Immunotoxicology.2005;2(1):51-58
• [10] Liss M. Eosinophilia. In Medscape Reference [online]. Availableat: www.emedicine.medscape.com/article/199879-overview

Identyfikatory

DOI

10.1515/med-2015-0014