[Edematous and painful leg. Pathophysiology in the spotlight: presentation of a case]. / Edema y dolor de pierna. La fisiopatología en el punto de mira: a propósito de un caso.

We report on a 74-year-old woman visually impaired and under treatment with amlodipine, valsartan and thyroid hormone. The patient complained of her unique, edematous and painful leg after a local trauma. The worsening was slow and gradual, affecting walk and state of mind. Several unsuccessful diagnoses were done before suspecting and confirming a Complex Regional Pain Syndrome. Edema disappeared dramatically after amlodipine empirical discontinuation. Pain improved gradually with rehabilitation exercises but, mainly, after gaining skills and self-esteem due to cataract surgery of her unique functional eye. It was necessary to decrease thyroid hormone dosage after a long lasting balance. The sympathetic nervous system role of the case is discussed.

Edema y dolor de pierna. La fisiopatología en el punto de mira: a propósito de un caso / Edematous and painful leg. Pathophysiology in the spotlight: Presentation of a case

Se presenta el caso de una mujer de 74 años con baja agudeza visual y en tratamiento con amlodipino, valsartán y hormona tiroidea. La paciente consulta por edema y dolor en su única pierna tras un traumatismo local. El empeoramiento es lento y progresivo con limitación de la deambulación y afectación significativa del estado de ánimo. Después de varios diagnósticos fallidos se sospecha y confirma un síndrome de dolor regional complejo. El edema desaparece drásticamente tras la retirada empírica de amlodipino. El dolor fue mejorando paulatinamente con ejercicios de rehabilitación pero, sobre todo, tras ganar destreza y autoestima con una cirugía de catarata de su único ojo funcionante. Hubo que disminuir la dosis de hormona tiroidea que había permanecido estable durante años. Se discute el papel del sistema nervioso simpático en la evolución del caso (AU)

We report on a 74-year-old woman visually impaired and under treatment with amlodipine, valsartan and thyroid hormone. The patient complained of her unique, edematous and painful leg after a local trauma. The worsening was slow and gradual, affecting walk and state of mind. Several unsuccessful diagnoses were done before suspecting and confirming a Complex Regional Pain Syndrome. Edema disappeared dramatically after amlodipine empirical discontinuation. Pain improved gradually with rehabilitation exercises but, mainly, after gaining skills and self-esteem due to cataract surgery of her unique functional eye. It was necessary to decrease thyroid hormone dosage after a long lasting balance. The sympathetic nervous system role of the case is discussed (AU)