Espin Diaz Paola Carolina, Singh Kawaljeet, Kher Pawani, Avanthika Chaithanya, Jhaveri Sharan, Saad Yosra, Ghosh Shankhaneel
General Practice, Universidad Internacional del Ecuador, Quito, ECU.
Medicine and Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, IND.
Cureus. 2022 Jul 25;14(7):e27239. doi: 10.7759/cureus.27239. eCollection 2022 Jul.
Periodic fever in children is an autoinflammatory illness with an unknown cause. Symptoms include frequent episodes of fever that are followed by an increase in inflammatory markers. A genetic background for periodic fever of unknown origin has been hypothesized, based on its family clustering and parallels to other autoinflammatory illnesses such as familial Mediterranean fever. Genome analysis has been used in studies to look for related gene variations in periodic fever of unknown origin in the pediatric population. Children with periodic fevers might be a diagnostic challenge. After ruling out the most prevalent causes, a wide variety of other possibilities are investigated. Infectious and noninfectious causes of periodic fever in children are discussed in this article. Inflammasomes (intracellular proteins that activate interleukin (IL)-1b and IL-18) and genetic/hereditary variations are thought to be implicated in the pathogenesis of periodic fever. Evaluation and ruling out possible infective or noninfective causes is vital in the diagnosis of periodic fever in children. Investigations demonstrate that there isn't a single gene linked to it, suggesting that it may have a multifactorial or polygenic origin, with an environmental trigger causing inflammasome activation and fever flares. Treatment is usually symptomatic, with drugs such as colchicine and cimetidine having shown promising results in trials. We explored the literature on periodic fever in children for its epidemiology, pathophysiology, the role of various genes and how they influence the disease and associated complications, and its various treatment modalities.
儿童周期性发热是一种病因不明的自身炎症性疾病。症状包括频繁发热,随后炎症标志物升高。基于其家族聚集性以及与其他自身炎症性疾病(如家族性地中海热)的相似性,推测不明原因周期性发热存在遗传背景。基因组分析已被用于研究儿科人群中不明原因周期性发热的相关基因变异。患有周期性发热的儿童可能是一个诊断难题。在排除最常见的病因后,会对多种其他可能性进行调查。本文讨论了儿童周期性发热的感染性和非感染性病因。炎性小体(激活白细胞介素(IL)-1β和IL-18的细胞内蛋白)以及遗传/遗传变异被认为与周期性发热的发病机制有关。评估并排除可能的感染性或非感染性病因对于儿童周期性发热的诊断至关重要。研究表明,不存在与之相关的单一基因,这表明它可能具有多因素或多基因起源,环境触发因素导致炎性小体激活和发热发作。治疗通常是对症治疗,秋水仙碱和西咪替丁等药物在试验中已显示出有前景的结果。我们查阅了关于儿童周期性发热的文献,以了解其流行病学、病理生理学、各种基因的作用以及它们如何影响疾病和相关并发症,以及其各种治疗方式。