[Eosinophilia-myalgia syndrome].

The eosinophilia-myalgia syndrome was first reported from New Mexico, USA, in 1989. Since then, there have been further reports from the USA, Canada and Europe. Patients with the eosinophilia-myalgia syndrome present with myalgias, morbilliform and urticarial rash, oedema, sclerodermiform lesions, fever, pneumonia, fatigue and peripheral eosinophilia (greater than 1,000/mm3). The ultimate cause is postulated to be a contamination produced by Bacterium amyloliquefaciens during the production of L-tryptophan by genetic engineering techniques. HPLC analysis revealed that the causative agent was a condensation product of 1 mole acetaldehyde and 2 moles tryptophan. Clinical and laboratory findings of the eosinophilia-myalgia syndrome, Shulman syndrome and toxic-oil syndrome are discussed.