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L-Tryptophan has been used as a sedative hypnotic for insomnia and as an antidepressant for many years.Previously reported toxicity has included nausea,vomiting,ataxia,hyperreflexia,possibly metabolite-induced bladder carcinogenesis,and worsening of hepatic encephalopathy in patients with a portocaval shunt.Recent reports from the Centers for Disease Control indicate that there may be an association between the use of L-tryptophan products and development of a syndrome of myalgias and eosinophilia.We report a case of the eosinophilia-myalgia syndrome without other known causes of eosinophilia and associated with use of an L-tryptophan product. When L-tryptophan was withdrawn,eosinophilia and the symptoms improved.The patient's resuming L-trypotphan dosing led to redevelopment of eosinophilia and diffuse myalgias. |
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