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RSD, A PREDISPOSING FACTOR ?


Hypersensitivity Reactions and Reflex Sympathetic Dystrophy: A Newly Discovered Predisposing Factor

Presenter: Keith Kenter, MD, Columbia, Mo Reporter:
Randall Ehrlich, MD, Department of Orthopedics,
Columbia-Presbyterian Medical Center, New York

Patients with known allergies and hypersensitivity reactions have an increased predisposition to develop reflex sympathetic dystrophy (RSD), according to research presented at the AAOS Specialty Day meeting of the American Orthopedic Society for Sports Medicine.

In the study group, 115 of the 230 patients had RSD, characterized by pain out of proportion to task, vasomotor disturbance, and improvement in symptoms with sympathetic block. The control group of 115 patients with no history of causalgia was age and gender matched to the study group.

Patients were given allergy questionnaires, and then underwent skin testing for immediate hypersensitivity reactions. All patients were Caucasian and 77.8% were female. The researchers found that 66.7% of the patients with RSD had allergies while 33.4% of the control group reported allergies (P<0.0001). In 72.2% of all cases, allergies were confirmed by skin testing. In addition, the authors reported that 61.5% of the study group had a history of adult-onset asthma.

The researchers conclude that patients with RSD are more likely to have hypersensitivity responses when compared with normal controls. They urge further research into this enigmatic and debilitating clinical entity.

Online Coverage from the American Academy of Orthopaedic Surgeons 65th Annual Meeting March 19 - 23, 1998. Co-author Keith Kenter, MD, and his colleagues at the Hospital for Special Surgery in New York City performed a retrospective review of 230 patients .