Rm. Taylor et al., A DIAGNOSTIC ALGORITHM FOR DISTINGUISHING THE EOSINOPHILIA-MYALGIA-SYNDROME FROM FIBROMYALGIA AND CHRONIC MYOFASCIAL PAIN, Journal of rheumatology, 23, 1996, pp. 13-18
Objective. To develop a diagnostic algorithm for the eosinophilia-myal
gia syndrome (EMS) that complements the existing case definition. Meth
ods. We conducted a retrospective study using data on 59 clinical and
laboratory variables from a consecutive referral cohort of 91 patients
with EMS meeting the Centers for Disease Control and Prevention case
definition. Age and sex matched controls included 93 patients with fib
romyalgia and 99 patients with chronic myofascial pain. The study peri
od was March 1989 to April 1992. Recursive partitioning was used to cr
eate a diagnostic algorithm. Results. In the 283 case patients and con
trols with disabling myalgias, 4 differentiating variables identified
patients with EMS: extremity edema, leukocyte count > 12.5x 10(9)/1, d
yspnea, and absence of arthralgias. These 4 variables form a diagnosti
c algorithm that has a sensitivity of 95.6%, a specificity of 96.9%, a
nd positive and negative predictive values of 93.5 and 97.9%, respecti
vely. Conclusion. This algorithm is practical and can be easily applie
d in any medical setting. It also readily distinguishes EMS from other
common myalgia syndromes.