Eosinophilia-myalgia Syndrome With Treatment and Prevention

By: Juliet Cohen

Eosinophilia myalgia syndrome (EMS) is an uncommon, multi-systemic, and chronic autoimmune disease caused by ingestion of impure L-tryptophan. It can impact any system structure, such as pulmomary, gastro-intestinal or the skin. A neuropathy with features of axonal degeneration has also been described in conjunction with eosinophilia myalgia syndrome. Generally considered to be incurable, eosinophilia myalgia syndrome does vary in its effects upon patients, however; some have severe manifestations and are quite injured, while no doubt some lucky persons may have completely recovered. Effects of the disease vary from death to recovery to occasional relapses to progressive illness. Almost any body system can be affected, so it's possible to find people with only one body system affected but most persons have at least two body systems affected.

In Eosinophilia myalgia syndrome. the causative broker seems to encourage a widespread incendiary response. Eosinophilia is a raised degree of a character of light-colored blood cubicle called an eosinophil. Similar to routine eosinophilia, it causes a growth in eosinophil granulocytes in the patient's blood. There are significant levels of eosinophils and inflammatory markers in the tissues and this immune response is thought to be the reason for the tissue damage that occurs to muscles, skin, nerves and other organs. Respiratory symptoms include shortness of breath, non-productive cough and pleuritic chest pain. After early pruritus and swelling, the skin becomes thickened and feels tight with changes that look like scleroderma. Unlike scleroderma, the fingers and the toes are usually spared, and there is no raynaud's phenomenon. Gastrointestinal symptoms are more rare and include dyspepsia, dysphagia or diarrhoea.

Eosinophilia myalgia syndrome is a disease that is rather difficult to diagnose, varies a plenty from individual to individual, and has no standardized handling, particularly in the chronic stage. In patients who had used tainted tryptophan, handling consisted of stopping the contaminated supplementation, best and foremost. Further treatment is usually symptomatic and supportive and may include analgesia and muscle relaxants. Prednisolone may be commenced and tapered off as symptoms resolve. Steroids seem to be of benefit in the short term but not in the long term. If there is pneumonia, it would be treated accordingly. If there is headache, then some kind of analgesic would be necessary. If there is skin involvement, perhaps various types of dermatologic creams, lotions, etc., might be used. 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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