Complex regional pain syndrome type I after diphtheria-tetanus (Di-Te) vaccination.

Bilić, Ervina and Bilić, Ernest and Žagar, Marija and Čerimagić, Denis and Vranješ, Davorka (2013) Complex regional pain syndrome type I after diphtheria-tetanus (Di-Te) vaccination. Collegium Antropologicum, 37 (3). pp. 1015-8. ISSN 0350-6134

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Abstract

Complex regional pain syndrome type I (CRPS I) is a disorder of one or more extremities characterized by pain, abnormal sensitivity (allodynia), swelling, limited range of motion, vasomotor instability, fatigue and emotional distress. The symptoms may be aggravated by even minor activity or weather change. It is usually provoked by injury, surgery or injection but in a small proportion of patients CRPS I develops without a clear causative event. There are several literature reports on CRPS after rubella and hepatitis B vaccination. We present a case of CRPS I affecting the left arm after diphtheria and tetanus (Di-Te) vaccination in the left deltoid muscle in a young girl having experienced profound emotional stress before the vaccination procedure. History data on previous minor trauma at the site of vaccination or emotional stress may necessitate temporary vaccination delay due to their proneness to impaired local or systemic immune response and CRPS as a complication of vaccination. If a child or an adult has prominent swelling and severe pain after vaccination, the diagnosis of CRPS I should be considered and if confirmed, the multidisciplinary treatment should start as soon as possible.

Abstract in Croatian

KOMPLEKSNI REGIONALNI BOLNI SINDROM TIP I NAKON CIJEPLJENJA PROTIV DIFTERIJE I TETANUSA (DI-TE) ----- Kompleksni regionalni bolni sindrom tip I (CRPS I) je poremećaj koji zahvaća jedan ili više ekstremiteta, a karakterizira se bolovima, smetnjama osjeta (alodinija), oticanjem, ograničenim opsegom kretnji, vazomotornom nestabilnošću, umorom i emocionalnim distresom. Do pogoršanja ovih simptoma mogu dovesti fizička aktivnost ili promjena vremenskih prilika. Pojavu ovog sindroma najčešće uzrokuje ozljeda, kirurški zahvat ili injekcija, a u manjem broju slučajeva uzrok ostaje nepoznat. U literaturi je opisano nekoliko slučajeva pojave CRPS-a nakon cijepljenja protiv rubeole i hepatitisa B. Prikazujemo slučaj pojave CRPS-a tip I na lijevoj ruci, nakon cijepljenja protiv difterije i tetanusa (Di-Te) u području lijevog deltoidnog mišića, kod djevojčice koja je prije cijepljenja bila pod dubokim emocionalnim stresom. Anamnestički podaci o ranijoj, čak i minimalnoj traumi u području u kojem se planira aplicirati cjepivo ili podatak o emocionalnom stresu mogu biti razlog odgode cijepljenja, kako bi se izbjegli lokalni i sustavni imunološki odgovori te CRPS kao moguća komplikacija cijepljenja. Ukoliko dijete ili odrasli pacijent ima izražen edem ekstremiteta te intezivnu bol nakon cijepljenja, mora se razmotriti dijagnoza CRPS-a, a ukoliko se ista potvrdi potrebno je što prije započeti s multidisciplinarnim liječenjem.

Item Type: Article
MeSH: Adolescent ; Arm ; Diphtheria-Tetanus Vaccine/adverse effects ; Edema/etiology ; Edema/immunology ; Female ; Humans ; Reflex Sympathetic Dystrophy/etiology ; Reflex Sympathetic Dystrophy/immunology
Departments: Katedra za pedijatriju
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Bilić, ErvinaUNSPECIFIED
Bilić, ErnestUNSPECIFIED
Žagar, MarijaUNSPECIFIED
Čerimagić, DenisUNSPECIFIED
Vranješ, DavorkaUNSPECIFIED
Date: September 2013
Date Deposited: 09 Apr 2015 10:32
Last Modified: 09 Apr 2015 10:32
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2219

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