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Hypersensitivity Pneumonitis and Pulmonary Vasculitis with Eosinophilia in a Patient Taking an L-Tryptophan Preparation

William D. Travis, MD; Michael E. Kalafer, MD; Howard S. Robin, MD; and F. J. Luibel, MD
[+] Article and Author Information

Requests for Reprints: William D. Travis, MD, Laboratory of Pathology, Building 10, Room 2N212, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.

Current Author Addresses: Dr. Travis: Laboratory of Pathology, Building 10, Room 2N212, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.

Dr. Kalafer: San Diego Pulmonary and Critical Care Medical Group, Sharp Cabrillo Hospital, 3475 Kenyon Street, San Diego, CA 92110.

Drs. Robin and Luibel: Department of Pathology, Sharp Cabrillo Hospital, 3475 Kenyon Street, San Diego, CA 92110.


Ann Intern Med. 1990;112(4):301-303. doi:10.7326/0003-4819-112-4-301
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Dietary intake of L-tryptophan tablets has recently been found to be associated with a potentially fatal disorder called the eosinophilia-myalgia syndrome (1, 2). This disorder is primarily characterized by peripheral blood eosinophilia and severe myalgias. We report a case of hypersensitivity pneumonitis and pulmonary vasculitis associated with eosinophilia in a patient taking an L-tryptophan preparation.

Case Report: A 70-year-old woman presented with a 1- to 2-week history of fatigue and weakness, cough with brown sputum, and several days of progressive dyspnea associated with bifrontal headache. An outpatient chest radiograph, 2 days before admission, showed bilateral perihilar and lower-lobe alveolar infiltrates,

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