We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |


Millicent Eidson, MA, DVM
JAMA. 1990;264(8):970. doi:10.1001/jama.1990.03450080055018.
Text Size: A A A
Published online


To the Editor.—  Clauw et al1 speculate that the pathogenesis of eosinophilia-myalgia syndrome may be related to abnormalities in tryptophan metabolism. Current epidemiologic evidence does not support this hypothesis.Our study,2 the first to provide evidence of a causal association between tryptophan-containing products and eosinophilia-myalgia syndrome, ascertained all high eosinophil counts at nine laboratories from May 1, 1989, to October 31, 1989, and found no cases of eosinophilia-myalgia syndrome with onset before July 1989. Of 429 cases reported to the Centers for Disease Control (CDC), Atlanta, Ga, by January 9, 1990, 87% reported symptom onset after July 1989.3 As of March 23, 1990, one thousand four hundred seventeen eosinophilia-myalgia syndrome cases have been reported in the United States, with 20 deaths. Seventy-six cases have been reported from other countries (CDC, Update Briefing, March 23, 1990). Since manufactured tryptophan has been consumed worldwide for years, problems with tryptophan metabolism


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.