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Overlap syndrome between Familial Mediterranean fever and tumor necrosis factor receptor-associated periodic syndrome in a lupus patient.
[familial mediterranean fever]
Autoinflammatory
diseases
represent
an
expanding
spectrum
of
genetic
and
non-genetic
inflammatory
diseases
characterized
by
recurrent
episodes
of
fever
and
systemic
inflammation
,
affecting
joints
,
skin
and
serosal
surfaces
.
Familial
Mediterranean
fever
(
FMF
)
is
the
most
common
autosomal
recessive
hereditary
autoinflammatory
disease
.
Tumor
necrosis
factor
receptor-associated
periodic
syndrome
(
TRAPS
)
is
an
autosomal
dominant
hereditary
autoinflammatory
disease
.
They
share
some
clinical
manifestations
such
as
a
periodic
fever
and
skin
rash
.
We
present
here
the
association
of
FMF
with
TRAPS
in
a
systemic
lupus
erythematosus
(
SLE
)
patient
.
A
54
-
year
-old
SLE
patient
with
recurrent
attacks
of
fever
,
arthritis
,
and
skin
rashes
was
referred
to
our
hospital
.
She
had
been
diagnosed
with
lupus
nephritis
at
19
years
old
.
Her
lupus
nephritis
was
controlled
by
steroid
treatments
;
however
,
since
childhood
she
has
suffered
from
recurrent
episodes
of
periodic
fever
,
abdominal
pain
,
arthritis
,
and
erythematous
skin
rashes
.
An
initial
diagnosis
of
FMF
was
suspected
based
on
the
genetic
analysis
,
showing
the
compound
heterozygous
L
110
P
/
E
148
Q
mutations
in
the
MEFV
gene
that
is
responsible
for
FMF
.
Her
symptoms
responded
to
colchicine
,
but
the
febrile
attacks
were
not
completely
resolved
.
Therefore
,
genetic
testing
for
TRAPS
was
performed
.
The
results
revealed
a
heterozygous
T
61
I
mutation
in
the
TNFRSF
1
A
gene
that
encodes
tumor
necrosis
factor
-α
receptor
and
is
responsible
for
TRAPS
.
The
patient
was
diagnosed
with
overlapping
FMF
and
TRAPS
,
in
addition
to
SLE
.
This
is
the
first
report
of
SLE
associated
with
both
FMF
and
TRAPS
.
Diseases
Validation
Diseases presenting
"arthritis"
symptom
acute rheumatic fever
child syndrome
congenital adrenal hyperplasia
cystinuria
familial hypocalciuric hypercalcemia
familial mediterranean fever
focal myositis
harlequin ichthyosis
homocystinuria without methylmalonic aciduria
inclusion body myositis
lamellar ichthyosis
malignant atrophic papulosis
pyomyositis
sneddon syndrome
trochlear dysplasia
typhoid
wiskott-aldrich syndrome
This symptom has already been validated