A high prevalence of autoimmune indices and disorders in primary nummular headache

Chen, Wei-Hsi; Chen, Yi-Ting; Lin, Chiu-Shen; Li, Tzu-Hui; Lee, Lian-Hui; Chen, Chun‐Jen

doi:10.1016/j.jns.2012.07.029

Cited by 23 publications

(22 citation statements)

References 23 publications

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“…The predilection of CRPS for females is also consistent with an autoimmune etiology. Beyond CRPS, a number of additional enigmatic pain syndromes may be supported by autoimmune mechanisms such as fibromyalgia and certain types of headaches [3, 6, 32]. By pursuing autoimmunity as a contributor to CRPS, we may uncover important new components of the disease process, delineate novel mechanisms for activation of the adaptive system of immunity, and discover new approaches to treatment of this disabling condition.…”

Section: Discussionmentioning

confidence: 99%

Autoimmunity contributes to nociceptive sensitization in a mouse model of complex regional pain syndrome

Guo

Shi

et al. 2014

Pain

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Complex regional pain syndrome (CRPS) is a painful, disabling, chronic condition whose etiology remains poorly understood. The recent suggestion that immunological mechanisms may underlie CRPS provides an entirely novel framework in which to study the condition and consider new approaches to treatment. Using a murine fracture/cast model of CRPS, we studied the effects of B-cell depletion using anti-CD20 antibodies or by performing experiments in genetically B-cell-deficient (µMT) mice. We observed that mice treated with anti-CD20 developed attenuated vascular and nociceptive CRPS-like changes after tibial fracture and 3 weeks of cast immobilization. In mice with established CRPS-like changes, the depletion of CD-20+ cells slowly reversed nociceptive sensitization. Correspondingly, µMT mice, deficient in producing immunoglobulin M (IgM), failed to fully develop CRPS-like changes after fracture and casting. Depletion of CD20+ cells had no detectable effects on nociceptive sensitization in a model of postoperative incisional pain, however. Immunohistochemical experiments showed that CD20+ cells accumulate near the healing fracture but few such cells collect in skin or sciatic nerves. On the other hand, IgM-containing immune complexes were deposited in skin and sciatic nerve after fracture in wild-type, but not in µMT fracture/cast, mice. Additional experiments demonstrated that complement system activation and deposition of membrane attack complexes were partially blocked by anti-CD20+ treatment. Collectively, our results suggest that CD20-positive B cells produce antibodies that ultimately support the CRPS-like changes in the murine fracture/cast model. Therapies directed at reducing B-cell activity may be of use in treating patients with CRPS.

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Section: Discussionmentioning

confidence: 99%

Autoimmunity contributes to nociceptive sensitization in a mouse model of complex regional pain syndrome

Guo

Shi

et al. 2014

Pain

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“…NH seems to be mainly a primary disorder, but secondary forms have been described: a fusiform extracranial aneurysm of the scalp, a cranial wall lesion, post‐transsphenoidal surgery for pituitary adenoma, meningioma in the left posterior fossa, arachnoid cysts, and Varicella‐zoster virus infection . Chen et al have noticed an extraordinarily high (65%) association of NH with autoimmune disorders, including Sjogren/sicca syndrome, rheumatoid arthritis, and antiphospholipid antibody syndrome.…”

Section: Resultsmentioning

confidence: 99%

Unusual Headache Syndromes

Queiroz

2013

Headache

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“…“Nummular headache” is also reported as a symptom of various diseases. Autoimmune disorders or structural lesions of the cranium, pituitary, or vasculature have been reported previously . Overly, 32% of patients had a history of brain trauma or surgery before NH development .…”

Section: Literature Reviewmentioning

confidence: 97%

“…Autoimmune disorders or structural lesions of the cranium, pituitary, or vasculature have been reported previously. 15,16,[18][19][20][21][22] Overly, 32% of patients had a history of brain trauma or surgery before NH development. 10,14,17,23,24 Insect bites and varicella-zoster virus infection were reported in individuals.…”

Section: Literature Reviewmentioning

confidence: 99%

Nummular Headache: 2 Cases With Good Beta Blocker Responses and a Narrative Review

Jiang

Liu

et al. 2019

Headache

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Objective To report 2 new nummular headache (NH) cases and review the clinical features and management of NH. Background NH is a coin‐shaped headache with a fixed shape and size. Since the first case series was reported by Pareja, approximately 300 cases have been reported. However, the latest treatment status and pathogenesis of NH remain unclear. Methods Two new NH cases with improved symptomatic responses to metoprolol were reported. We also conducted a narrative review of cases published in English aiming to provide the newest information about the clinical features and management of NH. Results Two NH patients with skin depressions within the painful area experienced significantly improvement with metoprolol. The literature review showed that NH was mainly moderate‐to‐severe in 77.8% (186/239) of the patients. Sensory dysfunction and focal trophic changes were reported in 47.8% (149/312) and 3.8% (12/312) of the patients, respectively. Gabapentin was the most commonly used and effective prophylactic, with a responder rate of 67.9% (55/81). Botulinum toxin type A was used for refractory NH, with an effective rate of 81.8% (9/11). Ten patients from the previous studies were prescribed β‐adrenergic blockers without any relief, and none of them reported focal tropic changes. Conclusions NH can be a disabling headache in more than half of identified patients and requires medical intervention. As with the previous treatment recommendations, gabapentin was the most commonly used prophylactic with a good response. Our cases suggested that β‐adrenergic blockers could be a therapeutic option for NH patients with focal trophic changes within the areas.

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A high prevalence of autoimmune indices and disorders in primary nummular headache

Cited by 23 publications

References 23 publications

Autoimmunity contributes to nociceptive sensitization in a mouse model of complex regional pain syndrome

Autoimmunity contributes to nociceptive sensitization in a mouse model of complex regional pain syndrome

Unusual Headache Syndromes

Nummular Headache: 2 Cases With Good Beta Blocker Responses and a Narrative Review

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