title: Complex regional pain syndrome, prototype of a novel kind of autoimmune disease.
abstract: Complex regional pain syndrome (CRPS) is a painful condition, which arises in a limb after trauma. CRPS can profoundly affect patients' quality of life, and there is no cure. CRPS is associated with limb-confined sensory, motor, skin, bone and autonomic abnormalities. Recent research has shown that some patients respond to treatment with immunoglobulins, and that a majority have IgG serum-autoantibodies directed against, and activating autonomic receptors. CRPS serum-IgG, when transferred to mice elicits abnormal behaviour. These results suggest that CRPS is associated with an autoantibody-mediated autoimmune process in some cases. CRPS has unusual features, including a non-destructive, and regionally-confined course. We propose that CRPS constitutes a prototype of a new kind of autoimmunity, which we term 'IRAM' (injury-triggered, regionally-restricted autoantibody-mediated autoimmune disorder with minimally-destructive course). Understanding autoimmune contribution to CRPS should allow the exploration of novel treatment modalities in the future. Additional 'functional' disorders, painful or painless may be autoimmune in nature.
authors.affiliation: Pain Research Institute, Department of Translational Medicine, Liverpool University, Liverpool, UK. andreasgoebel@rocketmail.com
authors.forename: Andreas
authors.initials: A
authors.lastname: Goebel
authors.forename: Franz
authors.initials: F
authors.lastname: Blaes
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000276:immunology*; D059350:Chronic Pain / Q000188:drug therapy / Q000276:immunology; D020918:Complex Regional Pain Syndromes / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors