The eosinophilia-myalgia syndrome: status of 205 patients and results of treatment 2 years after onset.
OBJECTIVE
To describe the course of the eosinophilia-myalgia syndrome during a 2-year period.


METHODS
15 physicians completed a structured review form to describe symptoms, physical findings, laboratory data, and responses to treatments in 205 patients with the eosinophilia-myalgia syndrome at the onset of illness and after 18 to 24 months of follow-up.


METHODS
15 university and private clinical practice settings.


METHODS
205 patients for whom follow-up data were available and who met four criteria at diagnosis: eosinophil count of 1000 cells/mm3 or greater; presence of fasciitis, peripheral neuropathy, polyradiculopathy, interstitial pulmonary disease, pulmonary hypertension, or myocardial involvement; history of L-tryptophan consumption; and absence of other conditions that could account for these findings.


METHODS
Empirical interventions by the physicians.


METHODS
Symptoms, physical findings, laboratory test results, biopsy findings, radiographic reports, therapeutic interventions, and responses to these interventions.


RESULTS
After 18 to 24 months, all symptoms except cognitive changes were reported to have improved in most patients. Nearly all physical findings were also reported to have improved or resolved in most patients; only peripheral neuropathy was unchanged. No evidence of ongoing inflammatory disease was reported. Prednisone was reported to be helpful in 79% of patients who received it during the acute phase of the syndrome. No other treatment was reported to be consistently beneficial.


CONCLUSIONS
18 to 24 months after the onset of illness, most symptoms and physical findings in most patients with the eosinophilia-myalgia syndrome resolved or improved. Cognitive changes were reported to be worse in 32% of patients. Prednisone was helpful in the acute phase of illness. No treatment was clearly valuable in management of the later phase of the syndrome.
Hertzman
P A
PA
Los Alamos Medical Center, New Mexico, USA.
Clauw
D J
DJ
Kaufman
L D
LD
Varga
J
J
Silver
R M
RM
Thacker
H L
HL
Mease
P
P
Espinoza
L R
LR
Pincus
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology; D016603:Eosinophilia-Myalgia Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis
D011241:Prednisone