Signs and symptoms

• Myalgia and muscle cramps with remissions and relapses
• Muscle weakness and fatigue
• Joint pain/Arthralgia
• Peripheral, facial and periorbital edema
• Non scarring alopecia
• Skin rash- macules to serpigenous lesions
• Pulmonary symptoms- dry cough or shortness of breath
• Neurological symptoms- paresthesias, numbness, burning sensation, and memory loss
• Gastrointestinal symptoms- Dysphagia, dyspepsia and diarrhea

Causes

• The exact cause for eosinophilic syndrome has not been found.
• The majority of the patents identified as having eosinophilia syndrome during the acute outbreak consumed L-tryptophan (97%) prior to the development of the syndrome.
• L-tryptophan is an essential amino acid found in many foods and has been available over the counter for insomnia, depression, and premenstrual symptoms.

Tests and diagnosis

• Complete blood count with absolute esinophil count
• Elevated creatine kinase levels
• Abnormal liver function tests
• Chest X-ray and pulmonary function tests

Complications

• Ascending polyneuropathy
• Cardiomyopathy
• Myocarditis
• Myocardial infarction
• Encephalopathy/stroke
• Thrombocytopenia

Treatment

Key factor in the treatment is stopping ingestion of L-tryptophan or any other agent that may be the offending factor.

High doses of corticosteroids may be helpful in acutely ill patients.