Chronicity of the eosinophilia-myalgia syndrome. A reassessment after three years.

OBJECTIVE

To define the natural history and outcome of eosinophilia-myalgia syndrome (EMS) among a cohort of patients followed up at one center since the onset of their disease.

METHODS

Fifty-seven patients with well-characterized EMS were evaluated prospectively at a university hospital for 21-64 months (mean 36 months).

RESULTS

Eighty-eight percent of the patients continue to have symptomatic disease with > 3 clinical manifestations. Fatigue (91%), muscle cramping (75%), myalgia (70%), paresthesias with objectively demonstrated hypesthesias (62%), articular symptoms (54%), scleroderma-like skin changes (44%), and proximal muscle weakness (40%) are the most common features of chronic EMS. New findings identified among this cohort include cognitive symptoms in 86% of the study group, tremor, and myoclonus.

CONCLUSION

The recognition of new manifestations in EMS and ongoing clinical disease in 88% of patients highlights the chronic nature of this disorder. Continued prospective followup of a large patient base is warranted to further define the natural history of this newly recognized illness.