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Rheumatology Advance Access originally published online on January 3, 2008
Rheumatology 2008 47(3):309-310; doi:10.1093/rheumatology/kem318
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© Published by Oxford University Press on behalf of the British Society for Rheumatology 2008.

New CIAS1 mutation and anakinra efficacy in overlapping of Muckle–Wells and familial cold autoinflammatory syndromes

L. Maksimovic1, J. Stirnemann1, F. Caux1,2, N. Ravet3, S. Rouaghe1, L. Cuisset4, E. Letellier1, G. Grateau3, A.-S. Morin1 and O. Fain1

1Service de Médecine Interne, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris, Université Paris 13, 2Service de Dermatologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris 13, 3Service de Médecine Interne, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Université Paris 6 and 4Laboratoire de Biochimie Génétique, Hôpital Cochin, Université Paris 5, Paris, France.

Correspondence to: N. Ravet, Service de Médecine Interne, Hôpital Tenon, 4 Rue de la Chine, 75020 Paris, France. E-mail: ravetnathalie73{at}yahoo.fr


   Abstract

Objectives. Muckle–Wells syndrome (MWS) and familial cold autoinflammatory syndrome (FCAS) are rare periodic fevers associated with CIAS1 mutations. A third entity, the chronic infantile neurological, cutaneous, articular (CINCA) syndrome was also recently associated with mutation in the same gene. A phenotypic and genotypic continuum seems to exist from the most benign (FCAS) to the most severe forms (CINCA). Although a CIAS1 mutation can be associated with two different phenotypes.

Methods. We report a family of three patients exhibiting the MWS and FCAS phenotypes. These phenotypes were associated with a novel missense mutation in CIAS1.

Results. Anakinra controlled inflammatory flares in the three patients.

Conclusions. FCAS, MWS and CINCA could be different phenotype expressions of the same disease.

KEY WORDS: Muckle–Wells syndrome (MWS), Familial cold autoinflammatory syndrome (FCAS), CIAS1, Anakinra, Cryopyrin-associated periodic syndromes (CAPS)

Submitted 19 June 2007; revised version accepted 31 October 2007.
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