Elevated IgM levels, edema, and fatigue syndrome.

Two patients with nonpitting edema associated with extreme fatigue were found to have hyperimmunoglobulinemia M and eosinophilia. Additional laboratory abnormalities included an elevated ESR and the presence of rheumatoid factor. One patient had the symptom complex continually, and it was controlled with minimal amounts of prednisone. The other patient had intermittent symptoms, with eosinophilia in the asymptomatic state and decreased eosinophil counts while symptomatic. His symptomatic episodes were diminished in duration by methylprednisolone. We believe these cases, which have been evaluated for eight and four years, respectively, constitute a new syndrome that has substantial morbidity, but that is apparently benign and that can be controlled with corticosteroids.