Screening of patients with complex regional pain syndrome for antecedent infections

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-I. 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 B19 in our CRPS population was 77%, which was significantly higher than in an independent Dutch population group (59%). Seroprevalence in lower extremity CRPS I (94%) was significantly higher than in upper extremity CRPS I patients (68%). In this study all patients were seropositive for varicella tester 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 if 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 B19 or other microorganisms in the etiopathogenesis of CRPS I.