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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]

Term Hierarchy

GTR
MeSH

CClinical test, RResearch test, OOMIM, GGeneReviews, VClinVar

CROGVEosinophilia myalgia syndrome

Abnormal cellular immune system morphology
- Abnormal leukocyte morphology
  - Abnormal leukocyte count
    - Abnormal granulocyte count
      - Abnormal eosinophil count
        Eosinophilia
        Eosinophilia myalgia syndrome

Professional guidelines

PubMed

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

Treatment of the eosinophilia-myalgia syndrome.

N Engl J Med 1990 Aug 9;323(6):417-8. doi: 10.1056/NEJM199008093230613. PMID: 2370894

See all (6)

Recent clinical studies

Etiology

Food contamination.

Rangan C, Barceloux DG
Dis Mon 2009 May;55(5):263-91. doi: 10.1016/j.disamonth.2009.01.003. PMID: 19362176

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 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

Panniculitis.

Ter Poorten MC, Thiers BH
Dermatol Clin 2002 Jul;20(3):421-33, vi. doi: 10.1016/s0733-8635(02)00008-6. PMID: 12170876

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

Collagen vascular disease.

DeSpain JD, Swinfard RW
Dermatol Clin 1992 Jan;10(1):1-18. PMID: 1730164

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

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

Unraveling the eosinophilia-myalgia syndrome.

Silver RM
Arch Dermatol 1991 Aug;127(8):1214-6. PMID: 1863082

Drug-related lupus.

Hess EV
Curr Opin Rheumatol 1991 Oct;3(5):809-14. doi: 10.1097/00002281-199110000-00010. PMID: 1751313

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

Eosinophilia-myalgia syndrome: the aftermath.

Sack KE, Criswell LA
South Med J 1992 Sep;85(9):878-82. doi: 10.1097/00007611-199209000-00005. PMID: 1523446

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

See all (46)

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

See all (42)