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[Reflex sympathetic dystrophy].

Ana P N Lotito1, Lúcia M M A Campos, Marialda H P Dias

  • 1Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP. paolalotito@ig.com.br

Jornal De Pediatria
|April 14, 2004
PubMed
Summary

Reflex sympathetic dystrophy in children presents with limb pain, edema, and vasomotor instability. Early diagnosis and treatment, including NSAIDs and physical therapy, can prevent functional impairment.

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Area of Science:

  • Pediatric Rheumatology
  • Pain Management

Background:

  • Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome, is a poorly understood condition causing chronic pain in children.
  • Early diagnosis and effective management are crucial to prevent long-term functional deficits.

Observation:

  • This study describes eight pediatric patients diagnosed with RSD based on clinical criteria including distal extremity pain, edema, vasomotor instability, and sensory impairment.
  • The majority of patients (7/8) presented with lower extremity involvement.
  • Comorbidities included systemic lupus erythematosus, juvenile idiopathic arthritis, and Glanzmann's thrombasthenia in some patients.

Findings:

  • Clinical manifestations consistently included pain, edema, and vasomotor instability in the affected limb (8/8), functional impairment (7/8), and sensory deficits (3/7).

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  • Laboratory findings were non-specific, with elevated erythrocyte sedimentation rate in three patients and abnormal bone scans in five.
  • Treatment with non-steroidal anti-inflammatory drugs and physical therapy led to symptom improvement in seven patients within six months.
  • Acupuncture showed positive results in three patients, and tricyclic antidepressants were effective in one severe case.

    • Implications:

    • Reflex sympathetic dystrophy should be considered in the differential diagnosis of pediatric limb pain to facilitate earlier identification.
    • Prompt diagnosis and intervention are essential to mitigate functional impairment and improve outcomes in children with RSD.