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Complex Regional Pain Syndrome Type I after Diphtheria-Tetanus (Di-Te) Vaccination
Ervina Bilić
; University of Zagreb, University Hospital Center, Department of Neurology, Zagreb, Croatia
Ernest Bilić
; University of Zagreb, University Hospital Center, Department of Pediatrics, Zagreb, Croatia
Marija Žagar
; University of Zagreb, University Hospital Center, Department of Neurology, Zagreb, Croatia
Denis Čerimagić
; General Hospital, Department of Neurology, Dubrovnik, Croatia
Davorka Vranješ
; University of Zagreb, University Hospital Center, Department of Neurology, Zagreb, Croatia
Abstract
Complex regional pain syndrome type I (CRPS I) is a disorder of one or more extremities characterized by pain, ab- normal 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 litera- ture 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 emo- tional stress before the vaccination procedure. History data on previous minor trauma at the site of vaccination or emo- tional 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.
Keywords
complex regional pain syndrome; diphtheria; tetanus; vaccination; adverse effects
Hrčak ID:
118325
URI
Publication date:
30.9.2013.
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