Reflex sympathetic dystrophy: An adverse reaction to immunotherapy

Reflex sympathetic dystrophy (RSD) has recently been redefined as a complex group of disorders that may develop as a consequence of t rauma affecting the limbs with or without an obvious nerve lesion. It consists of pain and related sensory abnormalities, abnormal blood flow and sweating, abnormalities in the motor system, and changes in structure of both superficial and deep tissues ("trophic changes")? RSD usually occurs after t rauma to the affected limb but may occur after a myriad of medical illnesses. 2 There are two case reports of RSD after vaccination with equine tetanus antitoxin?, 4 We believe this to be the first reported case after subcutaneous allergen immunotherapy.