title: Posttransplant distal limb syndrome.
abstract: The patient was a 45-year-old woman who was referred to a physical therapist and a physiatrist in a rehabilitation medicine department for evaluation and treatment of severe bilateral lower leg, ankle, and foot pain. The patient's past medical history was significant for sickle cell disease and she had undergone an allogeneic stem cell transplant 4 months prior with Sirolimus prescribed to prevent rejection. Magnetic resonance imaging of both lower legs revealed extensive bone marrow edema, as well as soft tissue swelling about the lower legs and ankles. These findings, along with the patient's presentation (constant bilateral pain and erythema of the lower legs within 6 months of transplantation) were found to be consistent with an atypical condition called posttransplant distal limb syndrome.
authors.affiliation: National Institutes of Health Clinical Center, Rehabilitation Medicine Department, Physical Therapy Section, Bethesda, MD, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Shrader
authors.forename: Galen O
authors.initials: GO
authors.lastname: Joe
mesh_terms: D000755:Anemia, Sickle Cell / Q000601:surgery*; D000842:Ankle; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D005528:Foot; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007866:Leg; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D053610:Opiate Alkaloids / Q000627:therapeutic use; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects*; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D053610:Opiate Alkaloids; D020123:Sirolimus