Twenty year follow up of a patient with a new de-novo NLRP3 mutation (S595G) and CINCA syndrome

Klin Padiatr. 2009 Nov-Dec;221(6):379-81. doi: 10.1055/s-0029-1239572. Epub 2009 Nov 4.

Abstract

We report on a 22-year-old girl with a history of recurrent febrile episodes, chronic arthritis, urticarial rash, and neurological symptoms including right hemiparesis, internal hydrocephalus, mental retardation, progressive deafness, and visual impairment. Treatment starting at age 20 months, including different combinations of immunosuppressive and antiinflammatory drugs such as corticosteroids and anti-TNFalpha antibody, was unsuccessful. Four years ago, we found a heterozygous S595G mutation in the NLRP3 gene of this patient. This prompted us to introduce anakinra, which resulted in considerable improvement of the patient's complaints.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Alleles*
  • Antirheumatic Agents / therapeutic use
  • Carrier Proteins / genetics*
  • Child
  • Child, Preschool
  • Cryopyrin-Associated Periodic Syndromes / diagnosis
  • Cryopyrin-Associated Periodic Syndromes / drug therapy
  • Cryopyrin-Associated Periodic Syndromes / genetics*
  • Cryopyrin-Associated Periodic Syndromes / immunology
  • DNA Mutational Analysis*
  • Female
  • Follow-Up Studies
  • Genetic Carrier Screening*
  • Humans
  • Infant
  • Interleukin 1 Receptor Antagonist Protein / deficiency
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use
  • Interleukin-1beta / blood
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • Young Adult

Substances

  • Antirheumatic Agents
  • Carrier Proteins
  • IL1RN protein, human
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-1beta
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • NLRP3 protein, human