Successful intravenous regional block with low-dose tumor necrosis factor-alpha antibody infliximab for treatment of complex regional pain syndrome 1.
Cytokines, particularly tumor necrosis factor-alpha, may play an important role in the mediation of mechanical hyperalgesia and autonomic signs in complex regional pain syndrome 1. We performed an IV regional block with low-dose administration of the tumor necrosis factor-alpha antibody, infliximab, in a patient with typical clinical signs of complex regional pain syndrome 1 (moderate pain, edema, hyperhidrosis, elevated skin temperature compared with the contralateral side). A significant improvement of clinical variables was observed 24 h after infliximab treatment. Almost complete remission was reached within 8 wk, but sensory signs improved only after 6 mo. No adverse events were observed.
Bernateck
Michael
M
Department of Anesthesiology, Pain Clinic, Hannover Medical School, Hannover, Germany. bernateck.michael@mh-hannover.de
Rolke
Roman
R
Birklein
Frank
F
Treede
Rolf-Detlef
RD
Fink
Matthias
M
Karst
Matthias
M
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D020918:Complex Regional Pain Syndromes / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008875:Middle Aged; D009407:Nerve Block; D017288:Pain Threshold; D012684:Sensory Thresholds; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab