Complex regional pain syndrome type I after diphtheria-tetanus (Di-Te) vaccination

Scientific paper - Original scientific paper

• Title (croatian): Kompleksni regionalni bolni sindrom tip I nakon cijepljenja protiv difterije i tetanusa (DI-TE)
• Author: Ervina Bilić
• Author: Ernest Bilić
• Author: Marija Žagar
• Author: Denis Čerimagić
• Author: Davorka Vranješ
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Complex regional pain syndrome type I (CRPS I) is a disorder of one or more extremities characterized by pain, abnormal sensitivity (allodynia), swelling, limited range of motion, vasomotor instability, fatigue and emotional distress. The symptoms may be aggravated by even minor activity or weather change. It is usually provoked by injury, surgery or injection but in a small proportion of patients CRPS I develops without a clear causative event. There are several literature reports on CRPS after rubella and hepatitis B vaccination. We present a case of CRPS I affecting the left arm after diphtheria and tetanus (Di-Te) vaccination in the left deltoid muscle in a young girl having experienced profound emotional stress before the vaccination procedure. History data on previous minor trauma at the site of vaccination or emotional stress may necessitate temporary vaccination delay due to their proneness to impaired local or systemic immune response and CRPS as a complication of vaccination. If a child or an adult has prominent swelling and severe pain after vaccination, the diagnosis of CRPS I should be considered and if confirmed, the multidisciplinary treatment should start as soon as possible.

Abstract (croatian)

Kompleksni regionalni bolni sindrom tip I (CRPS I) je poremećaj koji zahvaća jedan ili više ekstremiteta, a karakterizira
se bolovima, smetnjama osjeta (alodinija), oticanjem, ograničenim opsegom kretnji, vazomotornom nestabilnošću, umorom i emocionalnim distresom. Do pogoršanja ovih simptoma mogu dovesti fizička aktivnost ili promjena
vremenskih prilika. Pojavu ovog sindroma najčešće uzrokuje ozljeda, kirurški zahvat ili injekcija, a u manjem broju
slučajeva uzrok ostaje nepoznat. U literaturi je opisano nekoliko slučajeva pojave CRPS-a nakon cijepljenja protiv rubeole
i hepatitisa B. Prikazujemo slučaj pojave CRPS-a tip I na lijevoj ruci, nakon cijepljenja protiv difterije i tetanusa
(Di-Te) u području lijevog deltoidnog mišića, kod djevojčice koja je prije cijepljenja bila pod dubokim emocionalnim
stresom. Anamnestički podaci o ranijoj, čak i minimalnoj traumi u području u kojem se planira aplicirati cjepivo ili
podatak o emocionalnom stresu mogu biti razlog odgode cijepljenja, kako bi se izbjegli lokalni i sustavni imunološki
odgovori te CRPS kao moguća komplikacija cijepljenja. Ukoliko dijete ili odrasli pacijent ima izražen edem ekstremiteta
te intezivnu bol nakon cijepljenja, mora se razmotriti dijagnoza CRPS-a, a ukoliko se ista potvrdi potrebno je što prije
započeti s multidisciplinarnim liječenjem.

• Keywords (english): Adolescent; Arm; Diphtheria-Tetanus Vaccine/adverse effects; Edema/etiology; Edema/immunology; Female; Humans; Reflex Sympathetic Dystrophy/etiology; Reflex Sympathetic Dystrophy/immunology
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Collegium Antropologicum
• Numbering: vol. 37, no. 3, pp. 1015-1018
• p-ISSN: 0350-6134
• URN:NBN: urn:nbn:hr:105:155651
• Publication: 2013-09
• Document URL: https://hrcak.srce.hr/118325
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 20:13:58