临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (6): 579-.doi: 10.3969 j.issn.1000-3606.2015.06.020

• 罕见病 疑难病 • 上一篇    下一篇

Cryopyrin 蛋白相关周期综合征1 例报告

赵培伟,丁艳,尹薇,乐鑫,何学莲   

  1. 武汉市儿童医院( 湖北武汉 430016)
  • 收稿日期:2015-06-15 出版日期:2015-06-15 发布日期:2015-06-15
  • 通讯作者: 何学莲 E-mail:hexuelian 2013@hotmail.com

Cryopyrin-associated periodic syndrome: one case report

ZHAO Peiwei, DING Yan, YIN Wei, YUE Xin, HE Xuelian   

  1. Wuhan Children’s Hospital, Wuhan 430016, Hubei, China
  • Received:2015-06-15 Online:2015-06-15 Published:2015-06-15

摘要: 目的 探讨cryopyrin蛋白相关周期综合征(CAPS)的临床特点及其致病基因。方法 回顾性分析1例CAPS患儿的临床表现,实验室检查及基因检测的特点,同时复习相关文献。结果 男性患儿,7岁8个月,反复发热7年,全身红色斑片状皮疹,压之可褪色,不伴瘙痒,四肢及关节未见异常;超敏C反应蛋白、红细胞沉降率、类风湿因子升高;眼底动脉硬化,双结膜病变;两侧神经性耳聋。致病基因NLRP3编码区域未见突变,但在5’非编码区发现杂合突变(-2667G>T),其NLRP3基因mRNA水平为正常人的4.2倍,IL-1β和IL-18基因表达量也分别升高2.2倍(P=0.002)和1.2倍(P>0.05)。结论 CAPS可表现为体温反复升高、皮疹、关节受累,病程进展过程中可出现眼部异常及不同程度的耳聋。NLRP3基因检测有助诊断。

Abstract: Objective To investigate the clinical features and genetic basis of cryopyrin-associated periodic syndrome (CAPS). Methods The clinical manifestations, laboratory tests, and genetic tests of one case of CAPS were retrospectively analyzed. The related literatures were reviewed. Results A 7 year and eight month old male patient had recurrent fever for 7 years and his whole body was covered with patchy red rash which was itchy and faded with pressure. The limbs and joints were normal. The levels of high-sensitivity C-reactive protein, erythrocyte sedimentation rate, rheumatoid factors were increased. The patient had fundus arteriosclerosis, double conjunctival lesions and nerve deafness on both sides. There was no mutation found in NLRP3 gene coding region, but a heterozygous mutation (-2667G>T) had been found in 5 ' untranslated region. Compared with normal control, the mRNA level of NLRP3 increased 4.2 times and the expressions of IL-1β and IL-18 gene increased 2.2 (P=0.002) and 1.2 times (P>0.05). Conclusions The clinical features of CAPS can be recurrent fever, rash, and joint involved. The ophthalmologic abnormalities and varying degrees of deafness may occur during the progression. The test of NLRP3 gene may help diagnosis.