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Eosinophilia-myalgia syndrome (EMS), the connective tissue disorder first reported last year, has been linked to the health-food supplement tryptophan. But how a widely occurring amino acid could cause EMS has been unclear. This epidemiologic study of EMS cases from Oregon suggests that the outbreak in that state is strongly associated with tryptophan from a single Japanese manufacturer, raising the possibility of new insights into the pathogenesis of the disorder.
The investigators compared the brands of tryptophan used by 58 patients with EMS and 93 asymptomatic control subjects, and traced the sources back to the six Japanese companies that manufacture all of the tryptophan sold in the U.S. They found that 98 percent of the EMS cases, com…