title: Reduced severity of eosinophilia-myalgia syndrome associated with the consumption of vitamin-containing supplements before illness.
abstract: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  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 multivitamin-containing supplements before EMS appears to have modified the severity of subacute symptoms in this sample of cases from California.
authors.affiliation: Division of Field Services, Centers for Disease Control and Prevention, Atlanta, Ga.
authors.forename: D L
authors.initials: DL
authors.lastname: Hatch
authors.forename: L R
authors.initials: LR
authors.lastname: Goldman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002140:California; D016022:Case-Control Studies; D016603:Eosinophilia-Myalgia Syndrome / Q000139:chemically induced* / Q000473:pathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D012737:Sex Factors; D014364:Tryptophan / Q000009:adverse effects* / Q000378:metabolism; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins; D014364:Tryptophan