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October 25, 1993

Reduced Severity of Eosinophilia-Myalgia Syndrome Associated With the Consumption of Vitamin-Containing Supplements Before Illness

Author Affiliations

From the Division of Field Services, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Hatch); and Environmental Epidemiology and Toxicology Branch, California Department of Health Services, Emeryville (Dr Goldman).

Arch Intern Med. 1993;153(20):2368-2373. doi:10.1001/archinte.1993.00410200094011

Objective:  To determine if the severity of subacute symptoms in eosinophilia-myalgia syndrome (EMS) was affected by medical history or use of nutritional supplements other than tryptophan before illness.

Design and Study Population:  A case-control study was conducted of EMS cases systematically sampled from all those reported to a statewide surveillance system in California in 1989. Excluding two previous EMS-related deaths, interviews were completed in 73% (57/78) of the eligible case patients sampled.

Main Outcome Measures:  The severity of any myalgia(s), dyspnea, or walking impairment during each of the first 3 months of EMS was quantified by means of self-reported integer scores ranging from 0 (asymptomatic) to 10 (severe symptoms). Case patients in the top tercile of combined, unweighted monthly scores were defined as having severe symptoms.

Results:  All interviewees (57 of 57) had consumed supplemental tryptophan before illness; 89% (51/57) were female. The odds of severe symptoms were not significantly associated with gender, age, previous antidepressant use, or cumulative amounts of supplemental tryptophan consumed before or after EMS onset (P>.1). Previous consumption of any multivitamin(s), however, was associated with significantly lower odds of severe symptoms (adjusted odds ratio, 0.05; 95% confidence limits, 0.007, 0.4; P=.006).

Conclusions:  The consumption of multivitamincontaining supplements before EMS appears to have modified the severity of subacute symptoms in this sample of cases from California.(Arch Intern Med. 1993;153:2368-2373)