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Successful intravenous regional block with low-dose tumor necrosis factor-alpha antibody infliximab for treatment of complex regional pain syndrome 1. 2007

Michael Bernateck, and Roman Rolke, and Frank Birklein, and Rolf-Detlef Treede, and Matthias Fink, and Matthias Karst
Department of Anesthesiology, Pain Clinic, Hannover Medical School, Hannover, Germany. bernateck.michael@mh-hannover.de

Cytokines, particularly tumor necrosis factor-alpha, may play an important role in the mediation of mechanical hyperalgesia and autonomic signs in complex regional pain syndrome 1. We performed an IV regional block with low-dose administration of the tumor necrosis factor-alpha antibody, infliximab, in a patient with typical clinical signs of complex regional pain syndrome 1 (moderate pain, edema, hyperhidrosis, elevated skin temperature compared with the contralateral side). A significant improvement of clinical variables was observed 24 h after infliximab treatment. Almost complete remission was reached within 8 wk, but sensory signs improved only after 6 mo. No adverse events were observed.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009407 Nerve Block Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain. Chemical Neurolysis,Chemodenervation,Nerve Blockade,Block, Nerve,Blockade, Nerve,Blockades, Nerve,Blocks, Nerve,Chemical Neurolyses,Chemodenervations,Nerve Blockades,Nerve Blocks,Neurolyses, Chemical,Neurolysis, Chemical
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069285 Infliximab A chimeric monoclonal antibody to TNF-ALPHA that is used in the treatment of RHEUMATOID ARTHRITIS; ANKYLOSING SPONDYLITIS; PSORIATIC ARTHRITIS and CROHN'S DISEASE. Inflectra,Infliximab-abda,Infliximab-dyyb,MAb cA2,Monoclonal Antibody cA2,Remicade,Renflexis,Antibody cA2, Monoclonal,Infliximab abda,Infliximab dyyb,cA2, Monoclonal Antibody
D000893 Anti-Inflammatory Agents Substances that reduce or suppress INFLAMMATION. Anti-Inflammatory Agent,Antiinflammatory Agent,Agents, Anti-Inflammatory,Agents, Antiinflammatory,Anti-Inflammatories,Antiinflammatories,Antiinflammatory Agents,Agent, Anti-Inflammatory,Agent, Antiinflammatory,Agents, Anti Inflammatory,Anti Inflammatories,Anti Inflammatory Agent,Anti Inflammatory Agents
D000911 Antibodies, Monoclonal Antibodies produced by a single clone of cells. Monoclonal Antibodies,Monoclonal Antibody,Antibody, Monoclonal
D012684 Sensory Thresholds The minimum amount of stimulus energy necessary to elicit a sensory response. Sensory Threshold,Threshold, Sensory,Thresholds, Sensory
D014409 Tumor Necrosis Factor-alpha Serum glycoprotein produced by activated MACROPHAGES and other mammalian MONONUCLEAR LEUKOCYTES. It has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. Also known as TNF-alpha, it is only 30% homologous to TNF-beta (LYMPHOTOXIN), but they share TNF RECEPTORS. Cachectin,TNF-alpha,Tumor Necrosis Factor Ligand Superfamily Member 2,Cachectin-Tumor Necrosis Factor,TNF Superfamily, Member 2,TNFalpha,Tumor Necrosis Factor,Cachectin Tumor Necrosis Factor,Tumor Necrosis Factor alpha
D017288 Pain Threshold Amount of stimulation required before the sensation of pain is experienced. Pain Thresholds,Threshold, Pain,Thresholds, Pain

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