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2014 | 10 | 1 |
Article title

Eosinophilia-myalgia syndrome induced by
excessive L-tryptophan intake from cashew nuts

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Eosinophilia is characterized by more than 0.5
x 109 eosinophils per liter in the full blood count. A wide
range of conditions, from asthma to parasitic infections,
autoimmune diseases, and certain forms of cancer, have
been known to trigger abnormally high amount of eosinophils.
It is essential to reach the correct diagnosis and
treat the underlying disease aggresively. Definition of the
eosinophilia-myalgia syndrome was offered in 1980s by
Centers for Disease Control and Prevention for surveillance
purposes, and criteria were revised in 2001, with
high specificity. We report a case of 59-year old female who started a
special weight-reducing diet regimen that included excessive
cashew nut ingestion. Several months after she has
presented with periferal blood eosinophilia and constitutional
symptoms. Detailed work-up has not found elements
for haematological, systemic autoimmune, neoplastic or
infectious disease. She was diagnosed with eosinophilia-
myalgia syndrome due to extreme L-tryptophan intake,
a compound found in the cashew nut’s oil. She responded
well to cashew nut withdrawal and steroid therapy. In the
follow-up period she remained stable with normal eosinophil
count and there was not a need for any specific
Physical description
11 - 11 - 2014
  • [1] Holland SM, Gallin JI. Disorders of Granulocytes andMonocytes. In: Fauci AS et al. [ed.] Harrison’s Principles ofInternal Medicine, ed. 17. New York, McGraw-Hill Companies,2008:383
  • [2] Medsger, T.A. Eosinophilia-myalgia syndrome. In MedscapeReference [online]. Available at:
  • [3] Gotlib J. Eosinophilic disorders: Molecular pathogenesis, newclassification and mofern therapy. Best practice & ReasearchClinical Haematology. 2006;19(3):535-569
  • [4] Allen J.A., Paterson A., Sufit R., et al. Post-epidemiceosinophilia-myalgia syndrome associated with L-tryptopan.Arthritis & Rheumatism. 2011; 63 (11) 3633-3639
  • [5] de Araujo Guerra Grangeia T, Schweller M, Aparecida PaschoalI, et al. Acute respiratory failure as a manifestation ofeosinophilia-myalgia syndrome associated with L-tryptophanintake. J Bras Pulmol. 2007;33(6):747-751
  • [6] Noakes R, Spelman L, Williamsom R. Is the L-tryptophanmetabolite quinolonic acid responsable for eosinophilicfasciitis? Clin Exp Med. 2006; 6:60-64[Crossref]
  • [7] Hertzman PA, Clauw DJ, Duffy J. Rigorous new approach toconstructing a gold standard for validating new diagnosticcriteria, as exemplified by eosinohilia-myalgia syndrome. AnnIntern Med. 2001; 161: 2301-2306
  • [8] Dinic-Uzurov V, Lalosevic V, Milosevic I, et al. [Currentdifferential diagnosis of hypereosinophilic syndrome] MedPregl. 2007:LX (11-12):581-586[Crossref]
  • [9] Petterson R, Germolec D. Toxic Oli Syndrome: Review ofimmune aspects of the disease. J of Immunotoxicology.2005;2(1):51-58
  • [10] Liss M. Eosinophilia. In Medscape Reference [online]. Availableat:
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