Skepticism About Intravenous Immunoglobulin Treatment in Long-Standing Complex Regional Pain Syndrome

Abstract

Letters15 June 2010Skepticism About Intravenous Immunoglobulin Treatment in Long-Standing Complex Regional Pain SyndromeFrank Birklein, MD, PhD and Claudia Sommer, MD, PhDFrank Birklein, MD, PhDFrom University Medical Centre Mainz, Mainz 55131, Germany; and University of Würzburg, Würzburg 97080, Germany.Search for more papers by this author and Claudia Sommer, MD, PhDFrom University Medical Centre Mainz, Mainz 55131, Germany; and University of Würzburg, Würzburg 97080, Germany.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-12-201006150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the lively discussion with Dr. Goebel and colleagues on their pilot randomized, controlled trial on IVIG in patients with long-standing CRPS. We did not state that CRPS is of psychogenic origin or that patients with CRPS are psychiatrically ill in the classic sense. Although previous studies did not report strong psychosomatic factors, more vigorous and prospective testing might provide different results (1), and the experience of many researchers, which we systematically collected in the national German guideline of CRPS diagnosis and treatment (2), provide some indication that stressful life events (3), latent anxiety, posttraumatic stress disorder, ...