An Atypical Complex Regional Pain Syndrome Type 1 Following Diphtheria-Tetanus Vaccination

A 20-year-old male patient was admitted to Infectious diseases outpatient clinic with 25 days’ history of pain and swelling of the left hand and forearm. He had received a single dose of diphtheria tetanus-diphteria toxoid vaccine (Td; vaccines with reduced content of diphtheria toxoid) in the left deltoid muscle. The patient was diagnosed as Complex regional pain syndrome type 1. He was administered gabapentin (initial dose 1200 mg per day in two divided doses and maintenance dose 1800 mg per day, in three divided doses), etodolac 600 mg per day, acetylcystein 1200 mg per day, 3000 mg calcium carbonate with 8.8 mg colecalciferol at bed time and left upper extremity physiotherapy, including whirlpool, contrast bath and range of movement exercises. As a result, although complex regional pain syndrome type 1 (CRPS I) is a rare entity, it should be recognized in patients with severe pain, swelling and restricted extremity movement that occurred after immunization

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1. Muñoz-Gomez J, Collado A, Gratacós J, Campistol JM, Lomeña F, Llena J, Andreu. Reflex sympathetic dystrophy syndrome of the lower limbs in renal transplant patients treated with cyclosporin A. Arthritis Rheum. 1991;34(5):625-30.

2. Stanton-Hicks M, Jänig W, Hassenbusch S, Haddox JD, Boas R, Wilson P. Pain. 1995;63(1):127-33.

3. Durmuş O, Dandinoglu T, Cakar E, Dincer U, Tekin L, Kiralp MZ. Can Tetanus Vaccination Cause Complex Regional Pain Syndrome? Turk J Phys Med Rehab. 2013;16:22-4

4. Kwun BS, Park JW, Lee HJ, Kim AS, Ryu GH. Complex regional pain syndrome by vaccination: a case of complex regional pain syndrome after vaccination of influenza A(H1N1). Pediatr Int. 2012;54(3):4-6.

5. Jastaniah WA, Dobson S, Lugsdin JG, Petty RE. Complex regional pain syndrome after hepatitis B vaccine. J Pediatr. 2003;143(6):802-4.

6. Pontell D. A clinical approach to complex regional pain syndrome. Clin Podiatr Med Surg. 2008;25(3):361-80.

7. Wasner G, Schattschneider J, Binder A, Baron R. Complex regional pain syndrome-- diagnostic, mechanisms, CNS involvement and therapy. Spinal Cord. 2003;41(2):61- 75.

8. Albazaz R1, Wong YT, Homer-Vanniasinkam S. Complex regional pain syndrome: a review. Ann Vasc Surg. 2008;22(2):297-306.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )