European Journal of Pediatrics

, Volume 153, Issue 5, pp 344–346 | Cite as

Chronic fatigue: A peculiar evolution of Eosinophilia Myalgia Syndrome following treatment withl-tryptophan in four Italian adolescents

  • R. Priori
  • F. Conti
  • F. L. Luan
  • C. Arpino
  • G. Valesini
Original Paper


We describe four Italian adolescents in whom a persistent, debilitating fatigue appeared after therapeutic ingestion of products containingl-tryptophan and subsequent to the development of a transient rise in eosinophil count and severe myalgia (Eosinophilia Myalgia Syndrome-EMS). Their clinical picture was indistinguishable from that of the socalled Chronic Fatigue Syndrome. A chronic fatigue may occur after diverse triggering agents and it represents the peculiar clinical evolution of these four paediatric cases of EMS.

Key words

Eosinophilia Myalgia Syndrome Chronic Fatigue Syndrome l-Tryptophan Serotonin 



Chronic Fatigue Syndrome


Eosinophilia Myalgia Syndrome


antinuclear antibodies


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  1. 1.
    Bakheit AMO, Behan PO, Dinan TG, Gray CE, O'Keane V (1992) Possible upregulation of hypothalamic 5 hydroxytryptamine receptors in patients with post viral fatigue syndrome. BMJ 304:1010–1012PubMedGoogle Scholar
  2. 2.
    Bell KM, Cookfire D, Bell DS, Reese P, Cooper I (1991) Risk factor associated with chronic fatigue syndrome in a cluster of pediatric cases. Rev Infect Dis 13 [Suppl 1]:S32/8Google Scholar
  3. 3.
    Centers for Disease Control (1989) Eosinophilia-myalgia syndrome: New Mexico. MMWR 38:765–767Google Scholar
  4. 4.
    Culpepper RC, Williams RG, Mease PJ, Kalpsell TD, Kobayashi JM (1991) Natural history of the EMS. Ann Intern Med 115:437–442PubMedGoogle Scholar
  5. 5.
    Holmes GP, Kaplan JE, Gantz NM, Komaroff Al, Schonberger LB, Straus SE, Jones JF, Dubois RE, Cunningham-Rundles C, Pahwa S, Tosato G, Zegans LS, Purtilo DT, Brown N, Scholey RT, Brus I (1989) CFS: a working case definition. Ann Intern Med 108:387–389Google Scholar
  6. 6.
    Mayeno AN, Lin F, Foote CS, Loegering DA, Ames MM, Hedberg CW (1990) Characterization of “Peak E”, a novel amino acid associated with eosinophilia-myalgia syndrome. Science 250:1707–1708PubMedGoogle Scholar
  7. 7.
    Press RI, Peebles CL, Kumagai Y, Ochs RL, Tan EM (1992) Antinuclear antibodies in women with silicone breast implants. Lancet 340:1304–1307PubMedGoogle Scholar
  8. 8.
    Rikard-Bell CJ, Waters BGH (1992) Psychosocial management of chronic fatigue syndrome in adolescence. Aust NZ J Psychiatry 26:64–72Google Scholar
  9. 9.
    Varga J, Vitto J, Jimenez SA (1992) The cause and pathogenesis of Eosinophilia-Myalgia-Syndrome. Ann Intern Med 116:140–147PubMedGoogle Scholar
  10. 10.
    Varga J, Jimenez SA, Uitto J (1993) L-Tryptophan and the eosinophilia-myalgia syndrome: current understanding of the ethiology and pathogenesis. J Invest Dermatol 100:97S-105SCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • R. Priori
    • 1
  • F. Conti
    • 1
  • F. L. Luan
    • 1
  • C. Arpino
    • 1
  • G. Valesini
    • 2
  1. 1.Istituto di Clinica Medica IUniversità “La Sapienza”RomaItaly
  2. 2.Laboratorio di Epidemiologia e BiostatisticaIstituto Superiore di SanitàRomaItaly

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