Lamprecht P, Timmann C, Ahmadi-Simab K, Gross W L
Rheumaklinik Bad Bramstedt, Poliklinik für Rheumatologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
Internist (Berl). 2004 Aug;45(8):904-11. doi: 10.1007/s00108-004-1254-z.
Familial Mediterranean fever (FMF), hyperimmunoglobulinemia D periodic fever syndrome (HIDS), and tumor necrosis factor receptor-associated periodic syndrome (TRAPS) are hereditary periodic fever syndromes. FMF is caused by mutations in the Mediterranean fever gene, HIDS by mutations in the mevalonat-kinase gene, and TRAPS by mutations in the TNF-receptor superfamily 1A gene. Impaired function of the encoded proteins, i.e. pyrin in FMF, mevalonat-kinase in HIDS, and the p55 TNF-receptor in TRAPS, induces a dysregulated cytokine balance. Clinical manifestations are relapsing fever, serositis, arthralgia, myalgia, and miscellaneous forms of rash. The diagnosis is made through moleculargenetic analysis of mutations of the MEFV-gene (FMF), MVK-gene (HIDS), or TNFRSF1A-gene (TRAPS). Colchicine is the therapy of choice in FMF. HIDS is treated symptomatically. Impaired TNF-alpha regulation in TRAPS can be treated with etanercept.
家族性地中海热(FMF)、高免疫球蛋白D周期性发热综合征(HIDS)和肿瘤坏死因子受体相关周期性综合征(TRAPS)是遗传性周期性发热综合征。FMF由地中海热基因的突变引起,HIDS由甲羟戊酸激酶基因的突变引起,TRAPS由肿瘤坏死因子受体超家族1A基因的突变引起。所编码蛋白质(即FMF中的吡喃素、HIDS中的甲羟戊酸激酶和TRAPS中的p55肿瘤坏死因子受体)功能受损会导致细胞因子平衡失调。临床表现为复发性发热、浆膜炎、关节痛、肌痛和各种皮疹。通过对MEFV基因(FMF)、MVK基因(HIDS)或TNFRSF1A基因(TRAPS)的突变进行分子遗传学分析来做出诊断。秋水仙碱是FMF的首选治疗药物。HIDS采用对症治疗。TRAPS中肿瘤坏死因子-α调节受损可用依那西普治疗。