Periodic fever syndromes are a set of disorders characterized by recurrent episodes of
systemic and organ-specific
inflammation
Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...
. Unlike
autoimmune disorders such as systemic lupus erythematosus, in which the disease is caused by abnormalities of the
adaptive immune system
The adaptive immune system (AIS), also known as the acquired immune system, or specific immune system is a subsystem of the immune system that is composed of specialized cells, organs, and processes that eliminate pathogens specifically. The ac ...
, people with autoinflammatory diseases do not produce
autoantibodies
An autoantibody is an antibody (a type of protein) produced by the immune system that is directed against one or more of the individual's own proteins. Many autoimmune diseases (notably lupus erythematosus) are associated with such antibodies.
Pr ...
or antigen-specific T or B cells. Instead, the autoinflammatory diseases are characterized by errors in the
innate immune system
The innate immune system or nonspecific immune system is one of the two main immunity strategies in vertebrates (the other being the adaptive immune system). The innate immune system is an alternate defense strategy and is the dominant immune s ...
.
The syndromes are diverse, but tend to cause episodes of fever,
joint pains, skin rashes,
abdominal pain
Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given th ...
s and may lead to chronic complications such as
amyloidosis
Amyloidosis is a group of diseases in which abnormal proteins, known as amyloid fibrils, build up in tissue. There are several non-specific and vague signs and symptoms associated with amyloidosis. These include fatigue, peripheral edema, weigh ...
.
Most autoinflammatory diseases are genetic and present during childhood. The most common genetic autoinflammatory syndrome is
familial Mediterranean fever, which causes short episodes of fever, abdominal pain,
serositis
Serositis refers to inflammation of the serous tissues of the body, the tissues lining the lungs (pleura), heart (pericardium), and the inner lining of the abdomen (peritoneum) and organs within. It is commonly found with fat wrapping or creepin ...
, lasting less than 72 hours. It is caused by mutations in the
MEFV gene, which codes for the protein
pyrin.
Pyrin is a protein normally present in the
inflammasome. The mutated pyrin protein is thought to cause inappropriate activation of the inflammasome, leading to release of the pro-inflammatory cytokine
IL-1β. Most other autoinflammatory diseases also cause disease by inappropriate release of IL-1β. Thus, IL-1β has become a common
therapeutic target, and medications such as
anakinra,
rilonacept, and
canakinumab have revolutionized the treatment of autoinflammatory diseases.
However, there are some autoinflammatory diseases that are not known to have a clear genetic cause. This includes
PFAPA, which is the most common autoinflammatory disease seen in children, characterized by episodes of fever,
aphthous stomatitis
Aphthous stomatitis, or recurrent aphthous stomatitis (RAS), commonly referred to as a canker sore or salt blister, is a common condition characterized by the repeated formation of benignity, benign and non-contagious disease, contagious mouth ...
,
pharyngitis, and cervical
adenitis. Other autoinflammatory diseases that do not have clear genetic causes include
adult-onset Still's disease
Adult-onset Still's disease (AOSD) is a form of Still's disease, a rare systemic autoinflammatory disease characterized by the classic triad of fevers, joint pain, and a distinctive salmon-colored bumpy rash. The disease is considered a diagn ...
,
systemic-onset juvenile idiopathic arthritis,
Schnitzler syndrome, and
chronic recurrent multifocal osteomyelitis. It is likely that these diseases are multifactorial, with genes that make people susceptible to these diseases, but they require an additional environmental factor to trigger the disease.
Individual periodic fever syndromes
See also
*
Kawasaki disease - possible autoinflammatory mechanism
*
Multisystem inflammatory syndrome in children
Multisystem inflammatory syndrome in children (MIS-C), or paediatric inflammatory multisystem syndrome (PIMS / PIMS-TS), or systemic inflammatory syndrome in COVID-19 (SISCoV), is a rare systemic illness involving persistent fever and extreme ...
*
List of cutaneous conditions
Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the Human body, body and composed of Human skin, skin, hair, Nail (anatomy), nails, and related muscle and glands. The major function o ...
References
Further reading
*
Hobart A. Reimann, ''Periodic Disease: a probable syndrome including periodic fever, benign paroxysmal peritonitis, cyclic neutropenia and intermittent arthralgia.'' JAMA, 1948.
* Hobart A Reimann, ''Periodic Disease: periodic fever, periodic abdominalgia, cyclic neutropenia, intermittent arthralgia, angioneurotic edema, anaphylactoid purpura and periodic paralysis.'' JAMA, 1949.
* Hobart A Reimann, Moadié, J; Semerdjian, S; Sahyoun, PF, ''Periodic Peritonitis—Heredity & Pathology: report of seventy-two cases.'' JAMA, 1954.
* Hobart A Reimann, ''Periodic fever, an entity: A collection of 52 cases.'' AmJMedSci, 1962.
External links
{{Medical resources
, DiseasesDB = 9836
, ICD10 = {{ICD10, E, 85, 0, e, 85
, ICD9 = {{ICD9, 277.31
, ICDO =
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, MedlinePlus =
, eMedicineSubj = article
, eMedicineTopic = 952254
, MeshID = D056660
Understanding Autoinflammatory Diseasesnbsp;- US National Institute of Arthritis and Musculoskeletal and Skin Diseases
Inflammations
Autoinflammatory syndromes