Eosinophilia-myalgia syndrome is a rare condition that produces inflammation in the muscles, lungs, and skin. Patients with this syndrome also have elevated levels of eosinophils (white blood cells).
An epidemic of eosinophilia-myalgia syndrome in 1989 was found to be caused by tainted L-tryptophan supplements, although the precise substance that caused the contamination was not identified. The supplements involved in the epidemic had been manufactured using genetically engineered bacteria.
Since that time, some individuals have developed symptoms associated with this syndrome after taking sleep aids, weight loss supplements, and bodybuilding products containing L-tryptophan or 5-HTP. Diagnosis of this condition can be very difficult since it is so rare.
Doctors will need to perform blood tests to check the patient’s eosinophil count, and a physical examination will also be done to look for signs of inflammation throughout the body.
Treatment is based on the patient’s symptoms, and it may include corticosteroids to reduce inflammation and prescription pain relievers to effectively manage pain. Some patients might need to take diuretics, and hospitalization has been required in severe cases.
Signs and Symptoms of Eosinophilia-Myalgia Syndrome
The symptoms discussed below are some of those most frequently seen in patients with eosinophilia-myalgia syndrome.
1. Muscle Aches and Pains
Muscle aches and pains are one of the primary symptoms of eosinophilia-myalgia syndrome, and they are triggered by inflammation. Generally, they are most common in the arms and legs.
Most patients experience intense muscle aches and pains in the acute phase of this illness, and the pain may be severe enough that hospitalization is required. At a minimum, patients in the acute phase of the syndrome would certainly need to limit their physical activity.
Patients may have trouble walking or performing regular daily activities. To assess muscle pain, doctors can gently press on various muscle groups to check for tenderness, and they may also passively move the patient’s limbs.
Anti-inflammatory medications may help reduce muscle pain, and patients might also want to try massage and the use of ice packs or heating pads. During the chronic phase of the condition, some patients may enter remission. Exercising during this period seems to help with overall pain control.
2. Shortness of Breath
Shortness of breath could develop in patients whose lungs are affected by eosinophilia-myalgia syndrome. This symptom typically presents during the very early stages of the illness.
Patients could notice they feel short of breath after exercising or doing activities such as climbing stairs, and they might also have a cough. Since shortness of breath can have many different causes, individuals experiencing this symptom should see a healthcare provider for an examination.
At the appointment, patients should mention any other symptoms they have, particularly if they feel they may have symptoms associated with eosinophilia-myalgia syndrome. The doctor will perform a heart and lung exam.
They will listen to the patient’s lungs with a stethoscope, and patients might also need to have lung function tests.
Several inhaled medications can be prescribed to reduce shortness of breath, and patients might be advised to make modifications to their activities. If necessary, supplemental oxygen can be provided for patients who are severely short of breath.
3. Joint Pain
Joint pain is one of several symptoms that could occur during the early stage of eosinophilia-myalgia syndrome. For many patients, the early phase of the illness can last between three to six months.
Patients may notice pain in their elbows, shoulders, wrists, knees, hips, and ankles, and both fine and gross motor skills may be affected. For example, the joint pain could make it difficult for patients to write or open jars, and they might also have trouble walking up or down stairs.
Anti-inflammatory medications are normally effective for the treatment of joint pain, and patients with this symptom may want to try more powerful medications, too.
The joint pain associated with eosinophilia-myalgia syndrome typically occurs in conjunction with a tingling sensation in the arms, hands, legs, or feet.
The swelling (edema) associated with eosinophilia-myalgia syndrome most often affects the arms and legs, and it may also affect the face. Patients may notice only one limb is swollen, or they might have swelling in several limbs.
Patients experience edema with this condition due to the abnormal accumulation of fluid it provokes. Along with edema, patients might develop an intensely itchy rash, and the skin over swollen areas may thicken and harden.
Swelling normally presents in the acute phase of eosinophilia-myalgia syndrome, which lasts approximately three to six months. During the chronic phase of the condition, patients typically begin to experience the thickening and hardening of the skin over the swollen areas, most often in the arms and legs.
Doctors will assess swelling with a visual inspection, and they will gently touch the affected areas to check for fluid beneath the skin. They will also want to compare one side of the body to the other to see if the patient’s edema is worse on one side.
Patients may be prescribed corticosteroids to ease swelling, and home treatments such as ice packs might help patients feel more comfortable.
Fatigue may occur in all phases of eosinophilia-myalgia syndrome, and it can be severe for some patients. It may make it difficult or impossible to perform physical activity or daily activities, and patients might spend a much longer amount of time sleeping or resting than they did before developing eosinophilia-myalgia syndrome.
Doctors believe the fatigue could be due to the severe pain eosinophilia-myalgia syndrome causes; pain often results in disrupted sleep and depression, both of which are known to cause fatigue. To help doctors with a diagnosis, patients might want to keep a journal of their symptoms.
For example, it can be helpful to doctors to know the length of time the patient has been feeling fatigued, how many hours they spend resting or sleeping per day, and any activities that may have contributed to the fatigue.
Patients with this symptom may need to modify their activity schedule and get help with daily chores. Many patients experience relief from fatigue if they can reach remission.