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Eosinophilia-Myalgia Syndrome

F. Stuart Leeds, MD, MS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Eosinophilia-myalgia syndrome (EMS) is a rare syndrome presenting acutely with severe myalgia and elevated eosinophil count, with the subsequent development of chronic musculoskeleta...

DIAGNOSIS

  • The CDC criteria for the syndrome include all of the following (6):

    • Incapacitating myalgias

    • Blood eosinophil count >1 times 1,000/μL (but may be >10 times this level)

    • No evidence of infec...

TREATMENT

  • There is no specific treatment for EMS. Care is supportive.

  • There is no evidence to support the use of prednisone or other steroids.

MEDICATION

First Line

  • Muscle relaxants

  • NSAIDs

  • Diuretics for per...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patients may require close monitoring by a primary care physician. Patients may need prolonged rehabilitation services, in-home nursing care, and in severe cases,...

REFERENCES

1
Hertzman PA, Blevins WL, Mayer J, et al. Association of the eosinophilia-myalgia syndrome with the ingestion of tryptophan. N Engl J Med.  1990;322(13):869–873. {L-End} [View Abstrac...

CODES

ICD10

M35.8 Other specified systemic involvement of connective tissue 

ICD9

710.5 Eosinophilia myalgia syndrome 

SNOMED

  • 95416007 Eosinophilia myalgia syndrome

  • 403735006 Eosinophilia-myalgia syndrome f...

CLINICAL PEARLS

  • Ask all patients about their use of over-the-counter vitamins and supplements.

  • If suspecting EMS, first check a CBC for a markedly elevated absolute eosinophil count.

  • Steroids have no ro...

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