The First Scintigraphic Detection of Tumor Necrosis Factor-alpha in Patients with Complex Regional Pain Syndrome Type 1

Tumor necrosis factor (TNF)-α has been identified as a pathogenic factor in many immunologically based diseases and complex regional pain syndrome (CRPS). In this case series, we used radiolabeled technetium anti-TNF-α antibody to scintigraphically image TNF-α in 3 patients with type 1 CRPS. The results show that TNF-α was localized only in affected hands of patients with early-stage CRPS. No uptake was seen in clinically unaffected hands and late-stage CRPS. Our findings support the growing evidence for neuroimmune disturbance in patients with CRPS and may have important further implications for specific anticytokine treatment in patients with CRPS.