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Thursday, September 20, 2012
CRPS and Vaccines
Complex regional pain syndrome following immunization
1SAEFVIC, Department of General Medicine, Royal Children's Hospital (RCH), Melbourne, Victoria, Australia
2Department of Anaesthetics and Pain Management, Royal Children's Hospital, Melbourne, Victoria, Australia
3Department of Paediatrics, West Suffolk Hospital NHS Trust, Suffolk, UK
4Murdoch Children's Research Institute (MCRI), Melbourne, Victoria, Australia
5Paediatric Infectious Diseases Unit, Department of Paediatrics, Monash Children's Hospital, Southern Health, Monash University, Melbourne, Victoria, Australia
6Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
Correspondence toDr Nigel W Crawford, SAEFVIC Immunisation Safety Service, Department of General Medicine, Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, VIC 3052, Australia; firstname.lastname@example.org
Accepted 26 June 2012
Published Online First 1 August 2012
Complex regional pain syndrome type 1 (CRPS-1) is a clinical syndrome that affects one or more extremities and is characterised by persistent pain disproportionate to any inciting event, and at least one sign of autonomic dysfunction in the affected limb(s). The pathogenesis of this syndrome is poorly understood, but its onset is often precipitated by a physical injury, such as minor trauma, fracture, infection or a surgical procedure. In the literature, there are reports of CRPS-1 following immunization with rubella and hepatitis B vaccines. Here we present a case series of CRPS-1 following immunisation in adolescents, with either diphtheria-tetanus-acellular pertussis (1 case), or human papillomavirus vaccines (4 cases). Enhanced awareness of this syndrome and its potential to occur following immunization in the paediatric population is vital to the prompt and effective management of this condition.