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Letter to the Editor

An Atypical Complex Regional Pain Syndrome Type 1 Following Diphtheria-Tetanus Vaccination

Ergenekon Karagöz, Emre Ata, Murat Kosem, Emre Ersöz, Selim Akarsu, Vedat Turhan.


A 20-year-old male patient was admitted to Infectious diseases outpatient clinic with 25 days’ history of pain and swelling of the left hand and forearm. He had received a single dose of diphtheria tetanus-diphteria toxoid vaccine (Td; vaccines with reduced content of diphtheria toxoid) in the left deltoid muscle. The patient was diagnosed as Complex regional pain syndrome type 1. He was administered gabapentin (initial dose 1200 mg per day in two divided doses and maintenance dose 1800 mg per day, in three divided doses), etodolac 600 mg per day, acetylcystein 1200 mg per day, 3000 mg calcium carbonate with 8.8 mg colecalciferol at bed time and left upper extremity physiotherapy, including whirlpool, contrast bath and range of movement exercises. As a result, although complex regional pain syndrome type 1 (CRPS I) is a rare entity, it should be recognized in patients with severe pain, swelling and restricted extremity movement that occurred after immunization.

Key words: Complex regional pain syndrome, tetanus-diphteria toxoid vaccine, immunization

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