title: The first scintigraphic detection of tumor necrosis factor-alpha in patients with complex regional pain syndrome type 1.
abstract: Tumor necrosis factor (TNF)-alpha has been identified as a pathogenic factor in many immunologically based diseases and complex regional pain syndrome (CRPS). In this case series, we used radiolabeled technetium anti-TNF-alpha antibody to scintigraphically image TNF-alpha in 3 patients with type 1 CRPS. The results show that TNF-alpha was localized only in affected hands of patients with early-stage CRPS. No uptake was seen in clinically unaffected hands and late-stage CRPS. Our findings support the growing evidence for neuroimmune disturbance in patients with CRPS and may have important further implications for specific anticytokine treatment in patients with CRPS.
authors.affiliation: Department of Anesthesiology, Pain Clinic, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany. bernateck.michael@mh-hannover.de
authors.forename: Michael
authors.initials: M
authors.lastname: Bernateck
authors.forename: Matthias
authors.initials: M
authors.lastname: Karst
authors.forename: Klaus F
authors.initials: KF
authors.lastname: Gratz
authors.forename: Geerd J
authors.initials: GJ
authors.lastname: Meyer
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fischer
authors.forename: Wolfram H
authors.initials: WH
authors.lastname: Knapp
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koppert
authors.forename: Thomas
authors.initials: T
authors.lastname: Brunkhorst
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000493:pharmacokinetics; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D000069285:Infliximab; D007553:Isotope Labeling; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012019:Reflex Sympathetic Dystrophy / Q000097:blood*; D013669:Technetium Tc 99m Medronate; D014018:Tissue Distribution; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D014915:Whole-Body Counting; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D019275:Radiopharmaceuticals; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D013669:Technetium Tc 99m Medronate