To the Editor.—
Recently, a new syndrome has been described in association with the use of L-tryptophan and L-tryptophan-containing products. Although studies are ongoing as to whether L-tryptophan, its products, or contaminants are the cause of this syndrome, the majority of patients exhibiting a certain constellation of symptoms and laboratory abnormalities have reported the use of L-tryptophan.We describe a patient who fulfills the current criteria for having the eosinophilia-myalgia syndrome, and their cutaneous findings.
Report of a Case.—
A 32-year-old white woman initially presented to her internist in August 1989 with severe nonradiating musculoskeletal chest pain. Her only medications included a multivitamin, an oral contraceptive, and L-tryptophan. She had taken the latter for over 1 year. A complete physical examination was unremarkable, including the cardiopulmonary examination. Laboratory data revealed a white blood cell count of 15 × 109/L with 0.53 eosinophils. Electrocardiogram, chest roentgenogram, chemistry profile, urinalysis,