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Eosinophilia myalgia syndrome(EMS)

MedGen UID:: 38987
•Concept ID:: C0085179
•: Disease or Syndrome

Synonyms:	EMS; L-tryptophan induced EMS; Severe muscle pain and abnormally high eosinophils; Syndrome with inflammatory and autoimmune components that affect the skin, fascia, muscle, nerve, blood vessels, lung, and heart
SNOMED CT:	EMS - Eosinophilia myalgia syndrome (95416007); Eosinophilia myalgia syndrome (95416007)

Monarch Initiative:	MONDO:0004941

Definition

A complex systemic syndrome with inflammatory and autoimmune components that affect the skin, fascia, muscle, nerve, blood vessels, lung, and heart. Diagnostic features generally include eosinophilia, myalgia severe enough to limit usual activities of daily living, and the absence of coexisting infectious, autoimmune or other conditions that may induce eosinophilia. Biopsy of affected tissue reveals a microangiopathy associated with diffuse inflammation involving connective tissue. (From Spitzer et al., J Rheumatol Suppl 1996 Oct;46:73-9; Blackburn wd, Semin Arthritis Rheum 1997 Jun;26(6):788-93) [from MONDO]

Professional guidelines

PubMed

Analysis of Centers for Disease Control and Prevention criteria for the eosinophilia-myalgia syndrome in a geographically defined population.

Spitzer WO, Haggerty JL, Berkson L, Davis W, Palmer W, Tamblyn R, Laprise R, Mulder LJ
J Rheumatol Suppl 1996 Oct;46:73-9; discussion 79-80. PMID: 8895183

Criteria for the definition of the eosinophilia-myalgia syndrome.

Hertzman PA
J Rheumatol Suppl 1996 Oct;46:7-12. PMID: 8895176

The eosinophilia-myalgia syndrome: status of 205 patients and results of treatment 2 years after onset.

Hertzman PA, Clauw DJ, Kaufman LD, Varga J, Silver RM, Thacker HL, Mease P, Espinoza LR, Pincus T
Ann Intern Med 1995 Jun 1;122(11):851-5. doi: 10.7326/0003-4819-122-11-199506010-00008. PMID: 7741371

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Recent clinical studies

Etiology

Eosinophilic myopathic syndromes.

Pickering MC, Walport MJ
Curr Opin Rheumatol 1998 Nov;10(6):504-10. doi: 10.1097/00002281-199811000-00002. PMID: 9812210

Eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fasciitis with eosinophilia.

Bolster MB, Silver RM
Curr Opin Rheumatol 1994 Nov;6(6):642-9. doi: 10.1097/00002281-199411000-00016. PMID: 7865387

Toxic neuropathies and myopathies.

Kuncl RW, George EB
Curr Opin Neurol 1993 Oct;6(5):695-704. doi: 10.1097/00019052-199310000-00004. PMID: 8293140

The eosinophilia-myalgia syndrome and tryptophan.

Belongia EA, Mayeno AN, Osterholm MT
Annu Rev Nutr 1992;12:235-56. doi: 10.1146/annurev.nu.12.070192.001315. PMID: 1503805

Drug-induced myopathies.

Le Quintrec JS, Le Quintrec JL
Baillieres Clin Rheumatol 1991 Apr;5(1):21-38. doi: 10.1016/s0950-3579(05)80294-8. PMID: 2070426

See all (73)

Diagnosis

Eosinophilia in Rheumatologic/Vascular Disorders.

Tamaki H, Chatterjee S, Langford CA
Immunol Allergy Clin North Am 2015 Aug;35(3):453-76. Epub 2015 Jun 17 doi: 10.1016/j.iac.2015.05.001. PMID: 26209895

Eosinophilic fasciitis (Shulman disease).

Lebeaux D, Sène D
Best Pract Res Clin Rheumatol 2012 Aug;26(4):449-58. doi: 10.1016/j.berh.2012.08.001. PMID: 23040360

Eosinophilia myalgia syndrome.

Blackburn WD Jr
Semin Arthritis Rheum 1997 Jun;26(6):788-93. doi: 10.1016/s0049-0172(97)80022-4. PMID: 9213377

Eosinophilia-myalgia syndrome.

Kazura JW
Cleve Clin J Med 1991 May-Jun;58(3):267-70. doi: 10.3949/ccjm.58.3.267. PMID: 1893558

Eosinophilia-myalgia syndrome.

Broide DH
West J Med 1991 Apr;154(4):459. PMID: 1877190 Free PMC Article

See all (89)

Therapy

Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophan.

Turner EH, Loftis JM, Blackwell AD
Pharmacol Ther 2006 Mar;109(3):325-38. Epub 2005 Jul 14 doi: 10.1016/j.pharmthera.2005.06.004. PMID: 16023217

Eosinophilia myalgia syndrome.

Blackburn WD Jr
Semin Arthritis Rheum 1997 Jun;26(6):788-93. doi: 10.1016/s0049-0172(97)80022-4. PMID: 9213377

Eosinophilia-myalgia syndrome.

Kazura JW
Cleve Clin J Med 1991 May-Jun;58(3):267-70. doi: 10.3949/ccjm.58.3.267. PMID: 1893558

Eosinophilia-myalgia syndrome.

Broide DH
West J Med 1991 Apr;154(4):459. PMID: 1877190 Free PMC Article

Eosinophilia-myalgia syndrome.

Wilkins K, Wigle D
CMAJ 1990 Jun 1;142(11):1265-6. PMID: 2344580 Free PMC Article

See all (260)

Prognosis

Scleroderma-like disorders.

Foti R, Leonardi R, Rondinone R, Di Gangi M, Leonetti C, Canova M, Doria A
Autoimmun Rev 2008 Feb;7(4):331-9. Epub 2008 Jan 11 doi: 10.1016/j.autrev.2007.12.004. PMID: 18295739

Toxic oil syndrome and eosinophilia-myalgia syndrome: May 8-10, 1991, World Health Organization meeting report.

Philen RM, Posada M
Semin Arthritis Rheum 1993 Oct;23(2):104-24. doi: 10.1016/s0049-0172(05)80017-4. PMID: 8266108

Review of L-tryptophan and eosinophilia-myalgia syndrome.

Roufs JB
J Am Diet Assoc 1992 Jul;92(7):844-50. PMID: 1624654

The eosinophilia-myalgia syndrome and eosinophilic fasciitis.

Jimenez SA, Varga J
Curr Opin Rheumatol 1991 Dec;3(6):986-94. doi: 10.1097/00002281-199112000-00015. PMID: 1772754

Eosinophilia-myalgia syndrome: CDC update.

Auerbach SB, Falk H
Cleve Clin J Med 1991 May-Jun;58(3):215-7. doi: 10.3949/ccjm.58.3.215. PMID: 1654229

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Clinical prediction guides

Prediction of drug-induced eosinophilia adverse effect by using SVM and naïve Bayesian approaches.

Zhang H, Yu P, Xiang ML, Li XB, Kong WB, Ma JY, Wang JL, Zhang JP, Zhang J
Med Biol Eng Comput 2016 Mar;54(2-3):361-9. Epub 2015 Jun 5 doi: 10.1007/s11517-015-1321-8. PMID: 26044554

Eosinophilia myalgia syndrome.

Blackburn WD Jr
Semin Arthritis Rheum 1997 Jun;26(6):788-93. doi: 10.1016/s0049-0172(97)80022-4. PMID: 9213377

L-tryptophan and the eosinophilia-myalgia syndrome: current understanding of the etiology and pathogenesis.

Varga J, Jimenez SA, Uitto J
J Invest Dermatol 1993 Jan;100(1):97S-105S. doi: 10.1111/1523-1747.ep12356368. PMID: 8423409

Eosinophilia-myalgia syndrome in L-tryptophan-exposed patients.

Kamb ML, Murphy JJ, Jones JL, Caston JC, Nederlof K, Horney LF, Swygert LA, Falk H, Kilbourne EM
JAMA 1992 Jan 1;267(1):77-82. doi: 10.1001/jama.267.1.77. PMID: 1727200

Tryptophan toxicity: a pharmacoepidemiologic review of eosinophilia-myalgia syndrome.

Milburn DS, Myers CW
DICP 1991 Nov;25(11):1259-62. doi: 10.1177/106002809102501116. PMID: 1763543

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