Sag Erdal, Bilginer Yelda, Ozen Seza
Institute of Child Health, Pediatric Autoinflammatory Disease Programme, Hacettepe University, Ankara, Turkey.
Department of Pediatric Rheumatology, Hacettepe University Ihsan Dogramaci Children's Hospital, 06230, Sihhiye, Ankara, Turkey.
Curr Rheumatol Rep. 2017 Jul;19(7):41. doi: 10.1007/s11926-017-0670-8.
One purpose of this review was to raise awareness for the new autoinflammatory syndromes. These diseases are increasingly recognized and are in the differential diagnosis of many disease states. We also aimed to review the latest recommendations for the diagnosis, management, and treatment of these patients.
Familial Mediterranean fever (FMF), cryopyrin-associated periodic syndrome (CAPS), tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS), and hyperimmunoglobulinemia D and periodic fever syndrome/mevalonate kinase deficiency (HIDS/MVKD) are the more common autoinflammatory diseases that are characterized by periodic fevers and attacks of inflammation. Recently much collaborative work has been done to understand the characteristics of these patients and to develop recommendations to guide the physicians in the care of these patients. These recent recommendations will be summarized for all four diseases. FMF is the most common periodic fever disease. We need to further understand the pathogenesis and the role of single mutations in the disease. Recently, the management and treatment of the disease have been nicely reviewed. CAPS is another interesting disease associated with severe complications. Anti-interleukin-1 (anti-IL-1) treatment provides cure for these patients. TRAPS is characterized by the longest delay in diagnosis; thus, both pediatricians and internists should be aware of the characteristic features and the follow-up of these patients. HIDS/MVKD is another autoinflammatory diseases characterized with fever attacks. The spectrum of disease manifestation is rather large in this disease, and we need further research on biomarkers for the optimal management of these patients.
本综述的一个目的是提高对新的自身炎症性综合征的认识。这些疾病越来越受到认可,并且在许多疾病状态的鉴别诊断中。我们还旨在回顾针对这些患者的诊断、管理和治疗的最新建议。
家族性地中海热(FMF)、冷吡啉相关周期性综合征(CAPS)、肿瘤坏死因子受体相关周期性发热综合征(TRAPS)以及高免疫球蛋白D和周期性发热综合征/甲羟戊酸激酶缺乏症(HIDS/MVKD)是较常见的自身炎症性疾病,其特征为周期性发热和炎症发作。最近开展了大量合作研究,以了解这些患者的特征,并制定指导医生护理这些患者的建议。将对所有这四种疾病的最新建议进行总结。FMF是最常见的周期性发热疾病。我们需要进一步了解该疾病的发病机制以及单个突变在其中的作用。最近,对该疾病的管理和治疗已有很好的综述。CAPS是另一种伴有严重并发症的有趣疾病。抗白细胞介素-1(抗IL-1)治疗可为这些患者带来治愈。TRAPS的特点是诊断延迟时间最长;因此,儿科医生和内科医生都应了解这些患者的特征和随访情况。HIDS/MVKD是另一种以发热发作为特征的自身炎症性疾病。该疾病的临床表现范围相当广泛,我们需要进一步研究生物标志物,以实现对这些患者的最佳管理。