Periodic fever syndrome

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Background

  • Most of the periodic fever syndromes result in IL-1β production
Ethnicity Age at Onset Duration LNs AP MSK CP Rash Other Treatment
FMF Armenian, Arab, Jewish, Turkish <20 years 1-4 days rare very common sterile peritonitis monoarthritis of knee, ankle, wrist pleuritis, often unilateral rare erysipelas-like on legs pericarditis, scrotal attacks, splenomegaly colchicine
HIDS Dutch, French childhood 3-7 days cervical very common arthralgias, rare arthritis unusual very common, maculopapular hepatosplenomegaly, aphthous ulcers etanercept, IL-1 inhibitors
NAPS12 Guadeloupe, Italy neonatal 2-10 days yes yes arthralgias, myalgias yes urticaria/erythema cold sensitivity, headache
TRAPS mostly northern European, but all ethnic groups variable more than 5 days, up to weeks to months common common arthralgias, myalgias yes common erysipelas-like including arms periorbital edema, headache IL-1 inhibitors, TNF-α inhibitors, anti-IL6R mAb
CAPS all ethnic groups childhood/neonatal variable, depending on subtype very rare rarerare arthralgias, arthritis, bony overgrowth (depending on subtype) no urticaria, erythema cold sensitivity, deafness, aseptic meningitis, papilledema, dysmorphism (depending on subtype) IL-1 inhibitors
PFAPA all ethnic groups <5 years 3 to 6 days cervical common arthralgias rare common aphthous stomatitis, pharyngitis, headache corticosteroids, cimetidine, tonsillectomy
  • LNs=lymph nodes; AP=abdominal pain; MSK=musculoskeletal symptoms; CP=chest pain
  • From 1

References

  1. ^  Sinisa Savic, Laura J. Dickie, Michele Battellino, Michael F. McDermott. Familial Mediterranean fever and related periodic fever syndromes/autoinflammatory diseases. Current Opinion in Rheumatology. 2012;24(1):103-112. doi:10.1097/bor.0b013e32834dd2d5.