Reflex sympathetic dystrophy: Is the immune system involved?

• Published in: Archives of physical medicine and rehabilitation Vol. 79; no. 12; pp. 1549 - 1552
• Main Authors: Ribbers, Gerard M., Oosterhuis, Wytze P., van Limbeek, Jacques, de Metz, Menno
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.1998; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Case-Control Studies; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Female; Flow Cytometry; Fluorescent Antibody Technique, Direct; Humans; Inflammation; Lymphocyte Count; Lymphocyte Subsets - immunology; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Receptors, Interleukin-2 - blood; Reflex Sympathetic Dystrophy - blood; Reflex Sympathetic Dystrophy - diagnosis; Reflex Sympathetic Dystrophy - etiology; Reflex Sympathetic Dystrophy - immunology; T-Lymphocytes - immunology; Human; Flow cytometry; Evaluation; Nervous system diseases; Immune response; Cell population; Pathogenesis; Diseases of the autonomic nervous system; Metabolic activation; Reflex sympathetic dystrophy; Exploration; Lymphocyte
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/S0003-9993(98)90418-X

Objective: Evaluation of immune system function in patients with reflex sympathetic dystrophy (RSD). Design: Survey on blood samples obtained from RSD patients and from a randomly selected control group. The lymphocyte populations (T, B, NK cells), and the activated T cells (CD25, and HLA-Dr-positive CD4 and CD8 cells) were analyzed by flow cytometry with dual-color direct immunofluorescence after whole-blood lysis. Clinical chemistry parameters were analyzed in additional serum samples. Setting: Tertiary care center (outpatient rehabilitation clinic). Subjects: Thirteen patients (nine women) with RSD and a control group of 21 healthy individuals. Main Outcome Measures: The results of the flow cytometry analysis of RSD patients were related to those of the control subjects. Means were analyzed, and confidence intervals for differences of the means were calculated. The means of the clinical chemical analysis were related to local reference values. Results: The flow cytometry analysis did not differ between RSD patients and healthy controls. Although in some patients an individual parameter of clinical chemical analysis differed from its reference value, all of the mean values were within reference limits. Stratification on medications with immunomodulatory effects and on probability of a definite diagnosis of RSD had no influence on the results. Conclusion: No association between immunologic indices and RSD was found. This finding is relevant, because recent theories stress that it is not the sympathetic nervous sytem but a local inflammatory reaction that is fundamental in the pathogenesis of RSD. The results of this study do not support this theory.