vasoactive-intestinal-peptide and Reflex-Sympathetic-Dystrophy

Skin biopsies from patients with reflex sympathetic dystrophy were immunostained using a variety of antisera. An incidental finding with S100 staining was the presence of numerous Langerhans cells in the epidermis. All patients had significant pain at the time of biopsy, and all had symptoms refractory to treatment. The potential implications of this finding are discussed.

Topics: Adult; Aged; Biopsy; Calcitonin Gene-Related Peptide; Causalgia; Female; Fluorescent Antibody Technique; Hand; Humans; Langerhans Cells; Middle Aged; Nerve Fibers; Nerve Regeneration; Postoperative Complications; Reflex Sympathetic Dystrophy; S100 Proteins; Skin; Substance P; Tyrosine 3-Monooxygenase; Vasoactive Intestinal Peptide

In 1993, a study was undertaken at the Hand Clinics of Loyola University Medical Center in Chicago to investigate the role of the neuropeptides in the pathogenesis of Reflex Sympathetic Dystrophy. All of the patients had recurrent or continuous pain, swelling, and stiffness of one or both extremities following either acute trauma or surgical intervention. All of the patients showed a markedly increased level of bradykinin as well as calcitonin gene-related peptide. The levels of bradykinin were four times as high as the controls. A few showed increased levels of the other neuropeptides. With these results, we agree with Veldman, Goris and others who consider Reflex Sympathetic Dystrophy to be an exaggerated regional inflammatory disorder.

Topics: Adult; Aged; Bradykinin; Calcitonin Gene-Related Peptide; Female; Humans; Inflammation; Male; Middle Aged; Neuropeptides; Reflex Sympathetic Dystrophy; Substance P; Vasoactive Intestinal Peptide

Topics: Humans; Leg; Reflex Sympathetic Dystrophy; Vasoactive Intestinal Peptide