Georgin-Lavialle S, Kone-Paut I, Delaleu J, Sarrabay G, Grateau G, Touitou I, Hentgen V
Service de médecine interne, hôpital Tenon, 4, rue de la Chine, Assistance publique-Hôpitaux de Paris (AP-HP), université Paris 6, Pierre-et-Marie-Curie (UPMC), 75020 Paris, France; Centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, (CEREMAIA), France; INSERM UMRS_933, hôpital Trousseau, université Pierre-et-Marie-Curie (UPMC)-Paris 6, Assistance publique-Hôpitaux de Paris, 75012 Paris, France.
Centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, (CEREMAIA), France; Service de rhumatologie pédiatrique, université de Paris Sud, CHU de Bicêtre, Assistance publique-Hôpitaux de Paris, 94270 le Kremlin-Bicêtre, France.
Rev Med Interne. 2018 Apr;39(4):256-264. doi: 10.1016/j.revmed.2018.02.002. Epub 2018 Mar 7.
Tumour necrosis receptor associated periodic syndrome (TRAPS) is a rare cosmopolitan dominant autosomal disease that belongs to the group of recurrent autoinflammatory syndromes. TRAPS is characterized by recurrent bouts of fever lasting more than 7 days, with arthralgia, myalgia, abdominal pain, erythematous rash and sometimes ocular symptoms. During flares, raised inflammatory markers are constant. The age of onset may occur during childhood but also during adulthood. TRAPS is caused by mutations in the TNF receptor 1 (TNFRSF1A) gene that may occur in most of the populations over the world. In the majority of patients, history shows affected relatives, even if sporadic cases do exist. Management of TRAPS usually involves corticosteroid therapy during inflammatory flares. The most severe cases require a treatment with biological agents (mainly interleukin 1 inhibitors). The prognosis of TRAPS is overall good; the main risk is represented by the development of secondary inflammatory amyloidosis. This risk is greatest in patients with structural mutations leading to conformation abnormalities of the TNFRSF1A receptor. Regular clinical and biological monitoring is essential in the follow-up of TRAPS patients.
肿瘤坏死因子受体相关周期性综合征(TRAPS)是一种罕见的、全球范围内呈显性遗传的常染色体疾病,属于复发性自身炎症综合征。TRAPS的特征为反复发热,持续超过7天,并伴有关节痛、肌痛、腹痛、红斑皮疹,有时还伴有眼部症状。在发作期间,炎症指标持续升高。发病年龄可在儿童期,也可在成年期。TRAPS由肿瘤坏死因子受体1(TNFRSF1A)基因突变引起,这种突变可能发生在世界上大多数人群中。在大多数患者中,家族史显示有患病亲属,即使存在散发病例。TRAPS的治疗通常包括在炎症发作期间使用皮质类固醇疗法。最严重的病例需要使用生物制剂(主要是白细胞介素1抑制剂)进行治疗。TRAPS的总体预后良好;主要风险是继发性炎症性淀粉样变的发生。这种风险在具有导致TNFRSF1A受体构象异常的结构突变的患者中最大。定期的临床和生物学监测对于TRAPS患者的随访至关重要。