Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A syndrome of cold hyperalgesia associated with cold hypoaesthesia is described in 28 patients with peripheral polyneuropathy or mononeuropathy of various aetiologies. A mechanism of sensory disinhibition, where diminished cold-specific A delta input releases cold pain input carried by C nociceptors, is proposed to explain the hyperalgesia. In most patients, the symptomatic skin is abnormally cold. This is a likely consequence of vasospasm, due to sympathetic denervation supersensitivity, caused by dropout of sympathetic efferents as part of the small caliber nerve fibre insult. The term 'triple cold syndrome' is coined to describe this specific pathophysiological condition. Descriptively it is a mirror image of erythralgia, as described by Sir Thomas Lewis (1936) and updated by one of the present authors, a human condition also centred around anomalous primary nociceptor input, in which there is heat hyperalgesia and hot symptomatic skin due to C nociceptor sensitization and vasodilatation from antidromic discharge. Thus, like the latter condition, the triple cold syndrome emerges as an independent clinical entity with definable abnormal mechanisms which should be retrieved out of the all-embracing, descriptive, diagnostic category 'reflex sympathetic dystrophy--causalgia'.
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PMID:The triple cold syndrome. Cold hyperalgesia, cold hypoaesthesia and cold skin in peripheral nerve disease. 814 11

Secondary erythermalgia, as a symptom of an underlying illness, is characterized by burning pain in the extremities together with local erythema and warmth. The onset and clinical symptomatology of secondary erythermalgia in a woman with a 20 year history of systemic lupus erythematosus (SLE) is described. Histopathologic examination of affected skin areas revealed an inflammatory process compatible with vasculitis. These findings completely differ from the histopathology in erythromelalgia and in primary erythermalgia. The erythermalgic symptoms completely resolved by treatment with prednisone. We conclude that secondary erythermalgia in SLE in our patient was associated with cutaneous vasculitis.
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PMID:Secondary erythermalgia in systemic lupus erythematosus; [comment]. 844 Nov 37

Erythromelalgia is a rare syndrome characterized by pain, redness, and heat involving the lower and, less frequently, the upper extremities. Symptoms occur with local or environmental stimulation and may be mild for years or become disablingly severe. A finding of relief with ice-water immersion helps distinguish erythromelalgia from disorders such as causalgia and reflex sympathetic dystrophy. Erythromelalgia may be classified in three ways: (1) early-onset, (2) adult-onset aspirin-sensitive, and (3) adult-onset non-aspirin-sensitive. Treatment options, which include medication, sympathetic blocks, and surgery, are determined by classification.
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PMID:Erythromelalgia--a case study. 870 97

Erythromelalgia is a rare disorder characterized by burning pain of the extremities associated with red discoloration and increased temperature of the skin. We observed the effects of several drugs on two patients with primary erythromelalgia. Anti-inflammatory drugs such as aspirin had no effects for their symptoms. The alpha-adrenergic agonist midodrine slightly reduced skin temperature and redness of the extremities, and minimally reduced the pain in one patient. The partial alpha-adrenergic agonist and 5-hydroxytryptamine (5-HT) agonist/antagonist dihydroergotamine transiently reduced skin temperature and pain to some degree in one patient. The 5-HT and histamine antagonist cyproheptadine effectively relieved the burning pain and increased skin temperature.
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PMID:Treatment of primary erythromelalgia with cyproheptadine. 874 Jun 69

Several classifications have been proposed for erythermalgia according to causality (primary or secondary) or age of onset (presuming that all early-onset are primary). Recently a classification in three types of erythromelalgia have been proposed. Erythromelalgia and erythermalgia are defined as two independent and completely different disease entities. Clinically there are three different types of recurrent red, warm and burning pain in the extremities. That need to be distinguished for effective treatment according to their etiology: erythromelalgia in thrombocythaemia, primary erythermalgia and secondary erythermalgia. We recently observed 19 cases of erythermalgia; nine had primary erythermalgia; in 6 of 9, symptoms were relieved with aspirin. Ten of them had a secondary erythermalgia: 5 due to myeloproliferative disorders (erythromelalgia), 2 systemic lupus erythematosus and 3 to drugs. We used a two-level classification with a first level of primary or secondary erythermalgia, and a second level for primary erythermalgia, of familial or nonfamilial primary and for secondary erythermalgia, of thrombocythaemia disorders or other.
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PMID:[Classification of erythermalgia]. 875 86

The differential diagnosis of erythermalgia is sometimes complicated by the absence of consensus on proposed diagnostic criteria. Unwarranted diagnosis can result from any clinical situation leading to burning sensations in the limbs. This can occurs in patients with peripheral neuropathies who often experience dysesthesia when going to bed when the legs are under the covers; in such cases, redness and local warmth are missing. Venous insufficiency can also produce sensations of warm feet, often at retiring, together with edema and an increase in local heat. Algodystrophy, during the inflammatory phase can also mimic erythermalgia with intense pain and local modifications. Nevertheless, the unilateral aspect and persistence of the symptoms together with the post-traumatic situation usually directs the diagnosis. Acrodynia is a rare disease caused by excessive mercury intake and should be discussed in children. Vasomotor impairment in the limbs is the main sign. The red color of the hands and feet is accompanied by intense paroxysmal burn-type pain. The diagnosis is confirmed by high mercury levels in urine. Fabry's disease is a hereditary sphingolipidosis transmitted on chromosome X and occurs predominantly in men, often starting early in childhood with burning sensation in the limbs. The diagnosis should be entertained in children with pseudo-erythermalgia and is confirmed by chromatographic search for abnormal sphingolipids in the urine.
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PMID:[False erythermalgia]. 875 87

This retrospective review was performed to determine results and to present a new operative method, a modified Mitchell procedure, used to treat 13 adolescents with a total of 21 bunions. The average age of the patients was 14 years, 6 months. The average clinical followup period was 31 months. The average preoperative valgus angle was 35 degrees (range, 21 degrees-65 degrees); the average preoperative intermetatarsal angle was 14 degrees (range, 7 degrees-22 degrees). The early operative result for 17 feet (81%) was satisfactory; deformity, pain, or stiffness recurred in 4 feet (19%). At the time of the last clinic visit, the average hallux valgus angle was 15 degrees (range, 3 degrees-43 degrees); the average intermetatarsal angle was 7 degrees (range, 2 degrees-18 degrees). No instances of malunion, nonunion, infection, avascular necrosis, or transfer metatarsalgia occurred. This modification of the Mitchell procedure is an effective management option for mild to moderate adolescent hallux valgus.
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PMID:Modified Mitchell bunionectomy for management of adolescent hallux valgus. 891 59

Fifty consecutive patients with thrombocythemia (35 men and 15 women) were diagnosed as primary thrombocythemia (PT) in 30 and thrombocythemia associated with polycythemia vera (PV) in 20. The symptoms were platelet-mediated erythromelalgia in 16 PT and 15 PV, coronary artery disease in 3 PT and 2 PV, atypical cerebral ischemic attacks in 8 PT and 3 PV, paradoxical thrombosis and bleeding in 3 PT and 2 PV and hemorrhages alone in 6 PT and 2 PV patients. Erythromelalgia was localized in the forefoot sole and toes in 28, the fingertips in 9, the handpalm in 2. Untreated erythromelalgia progressed to acrocyanosis or peripheral ischemia with necrosis in a toe or fingertip in 14 cases. Painful red, warm and indurated erythromelalgic hot spots in the skin of the upper legs were misdiagnosed as superficial thrombophelebitis in 5 PT and 2 PV patients. Erythromelalgia in thrombocythemia already occurred at slightly increased platelet counts above 400 x 10(9)/l. The curative effect of aspirin on erythromelalgia in thrombocythemia was consistently accompanied by a significant increase of platelet counts. Erythromelalgia and bleeding paradoxically occurred in 5 patients at platelet counts between 1000 and 2000 x 10(9)/l. In this situation aspirin prevents erythromelalgic and microcirculatory circulation disturbances, but further increases the risk of serious bleeding complications. Presenting hemorrhagic manifestations in thrombocythemia were observed at platelet counts in excess of 1000 x 10(9)/l in 9 PT and 4 PV patients as severe epistaxis in 5, atypical ecchymoses in 3, gastrointestinal bleeding in 2 and secondary bleeding in 3. The concept of platelet-mediated erythromelalgia, thrombosis and hemorrhages in thrombocythemia is discussed.
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PMID:Erythromelalgic, thrombotic and hemorrhagic manifestations in 50 cases of thrombocythemia. 895 72

A standard Wu's bunionectomy consists of an oblique first metatarsal neck osteotomy with a lateral, proximal, and plantar displacement of the first metatarsal head and firm fixation of the osteotomy site with two Herbert screws. The outstanding features of this surgical technique include its surgical simplicity, secure fixation of the osteotomy site, no need for subsequent screw removal, ease of screw insertion, complete absence of screw breakage, little postoperative pain, and a relatively greater degree of correcting the various deformities associated with a hallus valgus foot than those normally achieved by either a Mitchell's bunionectomy or a Chevron bunionectomy.
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PMID:Modified Mitchell's bunionectomy (Wu's bunionectomy). 908 18

Erythromelalgia is a rare disease characterised by palmar and plantar erythema, burning pain and local increases in temperature. Erythromelalgia in adults most commonly appears secondary to myeloproliferative disorders, essential thrombocytosis and polycythemia vera; however, in children primary forms predominate. Erythromelalgia in children is characterised by a chronic relapsing course, usually refractory to treatment. We describe a case of erythromelalgia which developed in a 4.5 year old girl following influenza vaccination. Low dose aspirin, carbamazepine and propranolol induced a rapid resolution of the syndrome.
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PMID:Erythromelalgia following influenza vaccine in a child. 909 85


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