Nakamichi Seiko, Origuchi Tomoki, Fukui Shoichi, Yoda Aya, Matsubara Hiroshi, Nagaura Yuki, Nishikomori Ryuta, Abe Kuniko, Migita Kiyoshi, Sakamoto Noriho, Kawakami Atsushi, Ozono Yoshiyuki, Maeda Takahiro
Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Unit of Translational Medicine, Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Intern Med. 2019 Apr 1;58(7):1017-1022. doi: 10.2169/internalmedicine.1401-18. Epub 2018 Dec 18.
We herein report a case of a 75-year-old woman who presented with a low-grade fever, repeated cold-induced urticaria, and painful leg edemas with neutrocytosis. Because her mother also had cold-induced urticaria and her skin lesions histologically showed neutrophilic dermatitis, we suspected that she had familial cold autoinflammatory syndrome, a subtype of cryopyrin-associated periodic syndromes. Sequencing of the NLRP3 and MEFV genes revealed that she carried both the p.A439V missense mutation and p.E148Q homozygous mutation, which is commonly detected in familial Mediterranean fever patients. The administration of colchicine reduced the frequency and severity of her skin rash and leg edema.
我们在此报告一例75岁女性患者,其表现为低热、反复的冷诱导性荨麻疹、伴有中性粒细胞增多的腿部疼痛性水肿。由于她的母亲也有冷诱导性荨麻疹,且她的皮肤病变在组织学上显示为嗜中性皮病,我们怀疑她患有家族性冷自身炎症综合征,这是一种与冷吡啉相关的周期性综合征的亚型。NLRP3和MEFV基因测序显示,她同时携带p.A439V错义突变和p.E148Q纯合突变,这在家族性地中海热患者中很常见。秋水仙碱的使用降低了她皮疹和腿部水肿的发作频率及严重程度。