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Eosinophilia-Myalgia Syndrome Treatment & Management

  • Author: Thomas A Medsger, Jr, MD; Chief Editor: Herbert S Diamond, MD  more...
 
Updated: Jan 30, 2014
 

Medical Care

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  • 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 eosinophilic fasciitis.
  • Assistance with activities of daily living in either the inpatient or outpatient setting may be required because the myalgias and muscle cramps can be incapacitating.
  • Based on symptoms, patients may need hospital admission for evaluation and treatment.
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Consultations

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  • 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

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

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  • 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 Rheumatology

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

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, American College of Rheumatology

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Janssen<br/>Serve(d) as a speaker or a member of a speakers bureau for: Abbvie; Genentech; Pfizer; Questcor.

Chief Editor

Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; 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, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Carlos J Lozada, MD Director of Rheumatology Fellowship Training Program, Professor of Clinical Medicine, 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, American College of Rheumatology

Disclosure: Received honoraria from Pfizer for consulting; Received grant/research funds from AbbVie for other; Received honoraria from Heel for consulting.

Acknowledgements

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.

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