Phantom Limb Pain in Patients with Severe Cryoglobulinemic Vasculitis: Usefulness of Long-Term Pregabalin Treatment

Abstract

Background

Phantom limb pain [PLP] may complicate limb amputation. This symptom has been never described in patients with mixed cryoglobulinemia [MC] syndrome.

Findings

We observed three patients with hepatitis-C virus-related MC complicated by severe skin vasculitis responsible for gangrene needing limb amputation. After surgery, they developed refractory PLP and stump pain, which was successfully treated with pregabalin.

Conclusions

A clear improvement of PLP was observed in all patients during pregabalin; in addition, this treatment permitted an effective bed preparation and intensive medications of relapsing vasculitic ulcers in the stump, followed by complete resolution of skin lesions. At the same time, traditional analgesic therapies, potentially responsible for relevant side effects, were progressively tapered until discontinuation.

Keywords:

• Phantom limb pain
• pregabalin
• mixed cryoglobulinemia
• HCV
• cryoglobulinemic vasculitis