RESUMO
Hyperalgesia after a volar wrist tattoo with features consistent with complex regional pain syndrome and a brief literature review is presented. This is the first case of disseminated hyperalgesia reported from a tattoo. It could be related to the increased pain associated with wrist tattooing and the proximity to the palmar cutaneous branch of the median nerve. The response to prednisone was robust. Further cases may appear considering popularization of wrist tattoos by celebrities.
Assuntos
Síndromes da Dor Regional Complexa/etiologia , Hiperalgesia/etiologia , Tatuagem/efeitos adversos , Punho/fisiopatologia , Anti-Inflamatórios/uso terapêutico , Síndromes da Dor Regional Complexa/tratamento farmacológico , Síndromes da Dor Regional Complexa/fisiopatologia , Humanos , Hiperalgesia/tratamento farmacológico , Hiperalgesia/fisiopatologia , Masculino , Prednisona/uso terapêutico , Punho/inervação , Adulto JovemRESUMO
We report a 28-year-old man who presented with intestinal pseudo-obstruction as the initial manifestation of thymoma, myasthenia gravis, and dysautonomia. The patient's autoantibody profile was characteristic of this constellation of disorders, being positive for both muscle and ganglionic nicotinic acetylcholine receptor antibodies and striational antibody. Inflammatory cell infiltrates were found in the myenteric plexus of the stomach and small intestine. Review of 12 previously reported cases suggests that patients with both myasthenia gravis and dysautonomia in the context of thymoma respond poorly to therapy.
