Unexplained Nausea and Weight Loss in Two Cases of Longstanding CRPS

Dear Editor,Complex regional pain syndrome (CRPS) is a highly painful, limb-confined condition that arises usually after trauma ⇓. The objective of this letter is to highlight unusual presentations of nausea and rapid, dramatic, but then stabilizing weight loss associated with CRPS, which we observed in two of our patients. These are the only noted cases of this type among 190 cases of Budapest CRPS seen at our center since 2007 when a specialized service for this condition was set up.Other investigators have reported that patients with CRPS report with some regularity gastrointestinal (GI) symptoms including weight changes ⇓. In laboratory studies, we had previously demonstrated abnormal intestinal permeability in some patients ⇓, and other investigators have reported alterations in the GI microbial flora in patients with long-standing disease ⇓. To our knowledge, to date, there have been no case reports describing any association between distressing weight loss and CRPS. We hope that our communication can perhaps give an opening for other clinicians who might have encountered similar cases.The first case is of an 18-year-old female who suffered from relapsing/remitting CRPS involving the right shin and ankle, originally diagnosed by her orthopedic surgeon since she was 8 years old. …