The aim of this paper is to determine the involvement of tumour necrosis
factor-α (TNF-α) and interleukin (IL)-6 in
intermediate CRPS 1 as locally formed mediators of inflammation.
In this study, 25 patients with proven CRPS 1
(Bruehl criteria) were included. All patients participated in one
of our earlier studies during the acute stage of their disease.
After the disease developed into an intermediate stage, both the
disease activity and the profile of inflammatory mediators were
reevaluated. Disease activity and impairment were determined by
means of a visual analogue scale, the McGill Pain Questionnaire,
the difference in volume and temperature between the involved and
uninvolved extremities, and the reduction in active range of
motion of the involved extremity. Suction blisters were made on
the involved and uninvolved extremities for measurement of IL-6
and TNF-α. A significant improvement in
signs and symptoms of impairment was found. However, the levels of
IL-6 and TNF-α in blister fluid in the involved extremity
versus uninvolved extremity were still significantly raised.
Although signs and symptoms are
significantly improved, proinflammatory cytokines are still
increased in CRPS 1 affected extremities during the intermediate
stage of the disease. This indicates that the initiation and
sustained development of the disease are only partially affected by
proinflammatory cytokines. Follow-up in the chronic stage is
necessary to draw more definite conclusions about the existence of
a supposed relation between clinical signs and symptoms and the
level of proinflammatory cytokines.
