Giat Eitan, Lidar Merav
Isr Med Assoc J. 2014 Oct;16(10):659-61.
CAPS is a rare autoinflammatory disease associated with mutations in the NLRP3 gene that result in overactivation of the inflammasome, increased secretion of IL-1beta and IL-18, and systemic inflammation. Genetic testing has allowed for grouping of the three, previously distinct clinical syndromes of FCAS, MWS and NOMID, into a single syndrome termed CAPS. The clinical features include urticarial rash and fever, CNS and musculoskeletal involvement, ocular disorders and progressive deafness. Onset, severity and complications (mainly retardation, seizures, destructive arthropathy and amyloidosis) depend on the specific mutation. Diagnosis is determined by genetic tests but is often delayed due to lack of awareness. In Israel, the relative abundance of other autoinflammatory disorders (FMF, Behçet's disease) may result in misdiagnosis. Treatment is based on IL-1 antagonism, which usually results in prompt clinical response and may prevent amyloidosis.
冷吡啉相关周期性综合征(CAPS)是一种罕见的自身炎症性疾病,与NLRP3基因突变有关,该突变导致炎性小体过度激活、白细胞介素-1β(IL-1β)和白细胞介素-18(IL-18)分泌增加以及全身炎症。基因检测已使得以往三种不同的临床综合征——家族性冷自身炎症综合征(FCAS)、穆-韦二氏综合征(MWS)和新生儿多系统炎症疾病(NOMID)——被归为一种单一的综合征,即CAPS。其临床特征包括荨麻疹样皮疹和发热、中枢神经系统及肌肉骨骼受累、眼部疾病和进行性耳聋。发病情况、严重程度和并发症(主要是发育迟缓、癫痫发作、破坏性关节病和淀粉样变性)取决于具体的突变类型。诊断通过基因检测确定,但由于认识不足,诊断往往会延迟。在以色列,其他自身炎症性疾病(家族性地中海热、白塞病)相对常见,可能导致误诊。治疗基于白细胞介素-1拮抗作用,这通常会带来迅速的临床反应,并可能预防淀粉样变性。