Eosinophilia-myalgia syndrome - Diagnosis

Laboratory studies:Eosinophilia in peripheral blood, this is an essential element in the diagnosis of diseaseEosinophilia is present, especially in the early stages of diseaseNumbered between 10-eosinophils. 000 and 30. 000 cells / MicroLite-Eosinophilic bone marrow progenitor cells show hyperplasiaLeukocytosis, ranging from mild to moderateBe observed abnormal high transaminase levelsCreatine kinase is unusual high--Major basic protein serum levels and eosinophil-derived neurotoxin are high-High erythrocyte sedimentation rate is seen in one third of patientsLow-titre antinuclear antibodies are seen in half of patients.
Imaging Studies:Chest radiograph showed pulmonary infiltrates or normal. You can find infiltrates bibazilare pleurisy and a third of patients.MRI of the brain showed subcortical infarcts, focal lesions in deep white matter, cortical atrophy, ventricular dilatation and diffuse abnormalities and periventricular white matter.Pulmonary function tests show decreased diffusing capacity in half of patients without restrictive lung disease.Electrocardiography and echocardiography demonstrated atrial flutter, right ventricular hypertrophy, pericardial effusion and enlarged right ventricle with thickened mitral valve.Electrophysiological studies demonstrate myopathic and neuropathic changes in different degrees. Nerve conduction studies showed mixed demyelination and axonal degeneration.Histological examination showed muscle inflammatory infiltrates, often perivascular in endomisium and perimisium. Inflammatory cells are predominantly lymphocytes and histiocite, with rare eosinophils. Note the degeneration miofibrilara with denervation atrophy. The dermis is normal but perivascular infiltration with monocytes, eosinophils and lymphocytes without fibrinoid necrosis. Fasciitis can be distinguished from that of Eosinophilic.The differential diagnosis is made with the following diseases: Churg-Strauss syndrome, scleroderma, trichinosis, hypothyroidism, rheumatoid polimialgia, hypereosinophilic syndrome, toxic oil syndrome.