Screening of patients with complex regional pain syndrome for antecedent infections

Clin J Pain. 2001 Jun;17(2):110-4. doi: 10.1097/00002508-200106000-00002.


Objective: This study was designed to investigate whether Complex Regional Pain Syndrome type I (CRPS I) could be linked to any previous infection.

Patients: Fifty-two patients with CRPS I of one extremity were screened for the presence of antibodies against mostly neurotropic microorganisms.

Results: Of these 52 patients, none had antibodies against Treponema pallidum, Borrelia burgdorferi, or HTLV-1. Only four patients were positive for Campylobacter jejuni. For cytomegalovirus, Epstein-Barr virus, herpes simplex virus, and Toxoplasma gondii, seroprevalences were similar to control values. The total seroprevalence of Parvovirus B 19 in our CRPS population was 77%, which was significantly higher than in an independent Dutch population group (59%). Seroprevalence in lower extremity CRPS 1 (94%) was significantly higher than in upper extremity CRPS I patients (68%). In this study all patients were seropositive for varicella zoster virus (VZV) antibodies, but a high prevalence of VZV antibodies is similar to its prevalence in a normal population (>90%).

Conclusions: In this study we found a significantly higher seroprevalence of Parvovirus B19 in CRPS I and this is most striking in lower extremity CRPS I patients. Further serologic research in other geographic areas is needed to provide additional information about a potential role of Parvovirus B 19 or other microorganisms in the etiopathogenesis of CRPS I.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Antibodies / blood
  • Antibodies / isolation & purification
  • Campylobacter jejuni / immunology
  • Cytomegalovirus / immunology
  • Female
  • Herpesvirus 3, Human / immunology
  • Herpesvirus 4, Human / immunology
  • Humans
  • Infections / blood
  • Infections / complications*
  • Infections / immunology*
  • Male
  • Middle Aged
  • Parvovirus B19, Human / immunology
  • Reflex Sympathetic Dystrophy / blood
  • Reflex Sympathetic Dystrophy / complications*
  • Seroepidemiologic Studies
  • Serologic Tests
  • Simplexvirus / immunology
  • Toxoplasma / immunology


  • Antibodies