Eosinophilia-Myalgia Syndrome Treatment & Management

  • Author: Thomas A Medsger Jr, MD; Chief Editor: Herbert S Diamond, MD   more...
 
Updated: Jan 19, 2012
 

Medical Care

  • Stopping ingestion of L-tryptophan or any other agent that may be the offending factor is key in the treatment of patients with eosinophilia-myalgia syndrome (EMS).
  • Because of the protean manifestations of EMS, patients are treated based on their symptoms. No drug is known to alter the course of the disease. High doses of corticosteroids (eg, prednisone up to 60 mg/d) may be helpful in acutely ill patients, but the response is not nearly as dramatic as in patients with pure eosinophilic fasciitis.
  • Assistance with activities of daily living in either the inpatient or outpatient setting may be required because the myalgia and muscle cramps can be incapacitating.
  • Based on symptoms, patients may need hospital admission for evaluation and treatment.
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Consultations

  • Depending on the clinical features, consultation with a neurologist, rheumatologist, pulmonologist, or dermatologist may be needed. Consultation with a surgeon may be necessary for muscle, nerve, and fascial biopsies.
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Diet

  • Any over-the-counter medication or herbal supplement should be avoided until further information is available.
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Activity

  • Bed rest may be required for the intense muscle pain and cramps that occur during the acute phase of the illness.
  • During the chronic phase of the disease, strenuous physical activity may cause muscle pain and cramps and should be avoided if these symptoms occur.
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Contributor Information and Disclosures
Author

Thomas A Medsger Jr, MD  Gerald P Rodnan Professor of Medicine, Director, Scleroderma Research Program, Department of Medicine, University of Pittsburgh School of Medicine

Thomas A Medsger Jr, MD is a member of the following medical societies: American College of Epidemiology, American College of Rheumatology, American Federation for Medical Research, and Society for Epidemiologic Research

Disclosure: Nothing to disclose.

Coauthor(s)

Mohammed Mubashir Ahmed, MD  Associate Professor, Department of Medicine, Division of Rheumatology, University of Toledo College of Medicine

Mohammed Mubashir Ahmed, MD is a member of the following medical societies: American College of Physicians, American College of Rheumatology, and American Federation for Medical Research

Disclosure: Nothing to disclose.

Eisha Mubashir, MD  Fellow in Rheumatology, Department of Medicine, Fellow, Center of Excellence for Arthritis and Rheumatology, Louisiana State University Health Sciences Center, Shreveport

Disclosure: Nothing to disclose.

Shrilekha Sairam, MD, MBBS  Fellow, Department of Internal Medicine, Division of Rheumatology, University of Texas at Galveston

Disclosure: Nothing to disclose.

Specialty Editor Board

Carlos J Lozada, MD  Director of Rheumatology Fellowship Program, Professor, Department of Medicine, Division of Rheumatology and Immunology, University of Miami, Leonard M Miller School of Medicine

Carlos J Lozada, MD is a member of the following medical societies: American College of Physicians and American College of Rheumatology

Disclosure: Pfizer Honoraria Speaking and teaching; Amgen Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Lawrence H Brent, MD  Associate Professor of Medicine, Jefferson Medical College of Thomas Jefferson University; Chair, Program Director, Department of Medicine, Division of Rheumatology, Albert Einstein Medical Center

Lawrence H Brent, MD is a member of the following medical societies: American Association for the Advancement of Science, American Association of Immunologists, American College of Physicians, and American College of Rheumatology

Disclosure: Abbott Honoraria Speaking and teaching; Centocor Consulting fee Consulting; Genentech Grant/research funds Other; HGS/GSK Honoraria Speaking and teaching; Omnicare Consulting fee Consulting; Pfizer Honoraria Speaking and teaching; Roche Speaking and teaching; Savient Honoraria Speaking and teaching; UCB Honoraria Speaking and teaching

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Herbert S Diamond, MD  Adjunct Professor of Medicine, Division of Rheumatology, University of Pittsburgh School of Medicine; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, and Phi Beta Kappa

Disclosure: Merck Ownership interest Other; Smith Kline Ownership interest Other; Zimmer Ownership interest Other

References

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