Fibromyalgia, medical disorders associated with fibromyalgia,
and various psychiatric disorders may complicate the
assessment of the longterm illnesses caused by the
eosinophilia-myalgia syndrome (EMS). The effect of these
conditions on the evaluation of outcome in EMS is shown by
the use of clinical vignettes derived from a review of
medical records of patients with EMS. These observations have
implications for the clinical management of patients with a
history of EMS and for interpretation of studies of the
longterm outcome of EMS.
MCM: Discusses the difficulty of separating FM from EMS. FM
often preexeisted and was the cause of taking L-tryptophan,
and can complicate the diagnosis of EMS and the evaluation of
long-term outcome. The CDC definition for EMS was too
non-specific and there is considerable overlap in symptoms.
Moreover, FM often is associated with other medical disorders,
such as CFS, IBS, migraine, and atypical facial pain.
Psychiatric disorders (anxiety, mood) and chronic pain
disorders, factitious disorder, somatization, and conversion
disorder (the “dissimulating” disorders) can also overlap and
influence assessment of morbidity caused by EMS.