Overview
Eosinophilia myalgia syndrome is a rare disorder characterized by marked peripheral eosinophilia, associated with distinctive clinical features including nodular tenosynovitis, dermatitis, episodic swelling, and musculoskeletal pain 1.Diagnosis
Key Clinical Features: Marked peripheral eosinophilia, non-tender compressible articular nodules, dermatitis, episodic swelling, and muscle/joint pain 1.
Biopsy Findings: Tenosynovitis with necrotizing granulomas, non-specific vasculitis, eosinophil infiltration, and eosinophil degranulation evidenced by extracellular deposition of eosinophil granule major basic protein (MBP) 1.
Laboratory Tests: Elevated plasma levels of eosinophil granule MBP and eosinophil-derived neurotoxin (EDN) 1.Management
First-Line Treatment: Low-dose alternate-day prednisone 1.
Adjunctive Therapies: Not explicitly detailed in the provided abstracts; individualized management may be required based on symptom severity 1.Special Populations
Pediatrics: No specific information provided in the abstracts 1.
Elderly: No specific information provided in the abstracts 1.
Comorbidities: No specific guidance provided for managing comorbidities in the context of this syndrome 1.Key Recommendations
Initiate low-dose alternate-day prednisone for symptomatic relief in patients with confirmed eosinophilia myalgia syndrome (Evidence: Moderate) 1.
Consider biopsy evaluation of nodules for histopathological confirmation of eosinophil infiltration and degranulation (Evidence: Moderate) 1.
Monitor plasma levels of eosinophil granule MBP and EDN to assess disease activity and response to therapy (Evidence: Weak) 1.References
1 Butterfield JH, Leiferman KM, Gleich GJ. Nodules, eosinophilia, rheumatism, dermatitis and swelling (NERDS): a novel eosinophilic disorder. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 1993. link