Reflex sympathetic dystrophy: is the immune system involved?
OBJECTIVE
Evaluation of immune system function in patients with reflex sympathetic dystrophy (RSD).


METHODS
Survey on blood samples obtained from RSD patients and from a randomly selected control group. The lymphocyte populations (T, B, NK cells), and the activated T cells (CD25, and HLA-Dr-positive CD4 and CD8 cells) were analyzed by flow cytometry with dual-color direct immunofluorescence after whole-blood lysis. Clinical chemistry parameters were analyzed in additional serum samples.


METHODS
Tertiary care center (outpatient rehabilitation clinic).


METHODS
Thirteen patients (nine women) with RSD and a control group of 21 healthy individuals.


METHODS
The results of the flow cytometry analysis of RSD patients were related to those of the control subjects. Means were analyzed, and confidence intervals for differences of the means were calculated. The means of the clinical chemical analysis were related to local reference values.


RESULTS
The flow cytometry analysis did not differ between RSD patients and healthy controls. Although in some patients an individual parameter of clinical chemical analysis differed from its reference value, all of the mean values were within reference limits. Stratification on medications with immunomodulatory effects and on probability of a definite diagnosis of RSD had no influence on the results.


CONCLUSIONS
No association between immunologic indices and RSD was found. This finding is relevant, because recent theories stress that it is not the sympathetic nervous system but a local inflammatory reaction that is fundamental in the pathogenesis of RSD. The results of this study do not support this theory.
Ribbers
G M
GM
Department of Rehabilitation Medicine, Sint Maartenskliniek, Nijmegen, The Netherlands.
Oosterhuis
W P
WP
van Limbeek
J
J
de Metz
M
M
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005434:Flow Cytometry; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007249:Inflammation; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012019:Reflex Sympathetic Dystrophy / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology*
D015375:Receptors, Interleukin-2