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Phenotypic and genotypic characteristics of cryopyrin-associated periodic syndrome: a series of 136 patients from the Eurofever Registry.
[familial mediterranean fever]
To
evaluate
genetic
,
demographic
and
clinical
features
in
patients
with
cryopyrin-associated
periodic
syndrome
(
CAPS
)
from
the
Eurofever
Registry
,
with
a
focus
on
genotype-phenotype
correlations
and
predictive
disease
severity
markers
.
A
web-based
registry
retrospectively
collected
data
on
patients
with
CAPS
.
Experts
in
the
disease
independently
validated
all
cases
.
Patients
carrying
NLRP
3
variants
and
germline-
mutation
-negative
patients
were
included
.
136
patients
were
analysed
.
The
median
age
at
disease
onset
was
9
 
months
,
and
the
median
duration
of
follow-up
was
15
 
years
.
Skin
rash
,
musculoskeletal
involvement
and
fever
were
the
most
prevalent
features
.
Neurological
involvement
(
including
severe
complications
)
was
noted
in
40
%
and
12
%
of
the
patients
,
respectively
,
with
ophthalmological
involvement
in
71
%
,
and
neurosensory
hearing
loss
in
42
%
.
133
patients
carried
a
heterozygous
,
germline
mutation
,
and
3
patients
were
mutation
-negative
(
despite
complete
NLRP
3
gene
screening
)
.
Thirty
-
one
different
NLRP
3
mutations
were
recorded
;
7
accounted
for
78
%
of
the
patients
,
whereas
24
rare
variants
were
found
in
27
cases
.
The
latter
were
significantly
associated
with
early
disease
onset
,
neurological
complications
(
including
severe
complications
)
and
severe
musculoskeletal
involvement
.
The
T
348
M
variant
was
associated
with
early
disease
onset
,
chronic
course
and
hearing
loss
.
Neurological
involvement
was
less
strongly
associated
with
V
198
M
,
E
311
 
K
and
A
439
 
V
alleles
.
Early
onset
was
predictive
of
severe
neurological
complications
and
hearing
loss
.
Patients
carrying
rare
NLRP
3
variants
are
at
risk
of
severe
CAPS
;
onset
before
the
age
of
6
 
months
is
associated
with
more
severe
neurological
involvement
and
hearing
loss
.
These
findings
may
have
an
impact
on
treatment
decisions
.
Diseases
Validation
Diseases presenting
"early onset"
symptom
22q11.2 deletion syndrome
alexander disease
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
coats disease
cohen syndrome
congenital diaphragmatic hernia
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erythropoietic protoporphyria
fabry disease
familial mediterranean fever
homocystinuria without methylmalonic aciduria
inclusion body myositis
kindler syndrome
krabbe disease
papillon-lefèvre syndrome
primary hyperoxaluria type 1
pyruvate dehydrogenase deficiency
scrub typhus
sneddon syndrome
triple a syndrome
von hippel-lindau disease
werner syndrome
wolf-hirschhorn syndrome
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