Reduced severity of eosinophilia-myalgia syndrome associated with the consumption of vitamin-containing supplements before illness

• Published in: Archives of internal medicine (1960) Vol. 153; no. 20; p. 2368
• Main Authors: Hatch, D L, Goldman, L R
• Format: Journal Article
• Language: English
• Published: United States 25.10.1993
• Subjects: Adult; Age Factors; Aged; California; Case-Control Studies; Eosinophilia-Myalgia Syndrome - chemically induced; Eosinophilia-Myalgia Syndrome - pathology; Eosinophilia-Myalgia Syndrome - prevention & control; Female; Humans; Male; Medical History Taking; Middle Aged; Sex Factors; Tryptophan - adverse effects; Tryptophan - metabolism; Vitamins - administration & dosage; California
• ISSN: 0003-9926; 1538-3679
• DOI: 10.1001/archinte.1993.00410200094011

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. 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. 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. 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). The consumption of multivitamin-containing supplements before EMS appears to have modified the severity of subacute symptoms in this sample of cases from California.