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August 22, 1990


Author Affiliations

University of Illinois Chicago

University of Illinois Chicago

JAMA. 1990;264(8):969. doi:10.1001/jama.1990.03450080055015

In Reply.—  Dr Burdick and associates report they recently have seen five cases of the eosinophilia-myalgia syndrome. The Centers for Disease Control report (as of February 23, 1990) a total of 1321 case reports.1 They are unaware of any new cases with onset after December 1989. The dates of onset of Dr Burdick's cases are not noted, although they apparently occurred before January 1990.This problem clearly qualifies as an epidemic, currently of unknown etiology. It is unlikely to be due to tryptophan use alone because millions of people have ingested tryptophan in various forms with no significant ill effects. Even though the syndrome resembles toxic-oil syndrome, no contaminants of tryptophan have been found.2When I submitted my comments to JAMA regarding the use of tryptophan in insomnia, there were no reports of ill effects, and the few patients I knew of who were using it were having