Eosinophilia-Myalgia Syndrome Follow-up

Updated: Dec 01, 2017
  • Author: William E Monaco, MD; Chief Editor: Herbert S Diamond, MD  more...
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Follow-up

Further Outpatient Care

Because symptoms of EMS tend to be prolonged, sometimes persisting for years, intermittent treatment with muscle relaxants and analgesics may be required.

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Further Inpatient Care

Patients who are acutely ill with EMS may require hospitalization for supportive care, inpatient workup for infections, auto-immune diseases, neoplasms, and other mimics of EMS, and consideration of corticosteroid therapy.

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Inpatient & Outpatient Medications

Treatment is based on symptoms. Persistent pain requires analgesics. Muscle relaxants may be needed for the treatment of muscle spasms. A prolonged course of prednisone is neither effective nor indicated.

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Transfer

Incapacitating myalgias may require transfer to a skilled nursing facility or rehabilitation unit for assistance with activities of daily living.

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Deterrence/Prevention

Exercise may result in relapse of myalgias in some patients, and they should be advised to avoid any activities that cause or worsen symptoms.  Patients should avoid L-tryptophan and other possible causative medication(s) or supplement(s).

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Complications

Serious and life-threatening complications (eg, ascending polyneuropathy, cardiomyopathy, myocarditis, myocardial infarction, encephalopathy, stroke, thrombocytopenia) have been reported, but they occur only rarely.

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Prognosis

Most patients (90%) continue to have some symptoms 3-4 years after the acute presentation. These are likely due to permanent tissue damage that occurred in the acute phase of the disease.  Persistent muscle pain, fatigue, and muscle spasm were the most common residual complaints.  Subjective memory loss and word-finding difficulties were also reported in this series. These symptoms were not responsive to any therapeutic intervention.  Patients who had severe disease at onset with internal organ involvement, neurologic findings, and skin thickening tended to have a worse prognosis [28] .

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Patient Education

Patients should be advised that over-the-counter medications are not subjected to rigorous testing for short- or long-term side effects. Their use could result in as yet unknown adverse health consequences.

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