array:23 [
  "pii" => "S1699258X20300103"
  "issn" => "1699258X"
  "doi" => "10.1016/j.reuma.2019.12.002"
  "estado" => "S300"
  "fechaPublicacion" => "2021-02-01"
  "aid" => "1386"
  "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología"
  "copyrightAnyo" => "2020"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Reumatol Clin. 2021;17:118-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1699258X19300324"
    "issn" => "1699258X"
    "doi" => "10.1016/j.reuma.2019.01.003"
    "estado" => "S300"
    "fechaPublicacion" => "2021-02-01"
    "aid" => "1321"
    "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Reumatol Clin. 2021;17:120"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 29
      "formatos" => array:2 [
        "HTML" => 23
        "PDF" => 6
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
      "titulo" => "La distensi&#243;n h&#237;drica en las capsulitis de hombro"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "120"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Hydric distension of shoulder capsulitis"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Moreen Mei&#223;ner, Cayetano Alegre de Miquel"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Moreen"
              "apellidos" => "Mei&#223;ner"
            ]
            1 => array:2 [
              "nombre" => "Cayetano"
              "apellidos" => "Alegre de Miquel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173574321000010"
        "doi" => "10.1016/j.reumae.2019.01.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574321000010?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X19300324?idApp=UINPBA00004M"
    "url" => "/1699258X/0000001700000002/v2_202107140854/S1699258X19300324/v2_202107140854/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1699258X19301214"
    "issn" => "1699258X"
    "doi" => "10.1016/j.reuma.2019.07.007"
    "estado" => "S300"
    "fechaPublicacion" => "2021-02-01"
    "aid" => "1360"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Reumatolog&#237;a y Colegio Mexicano de Reumatolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Reumatol Clin. 2021;17:116-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 14
      "formatos" => array:2 [
        "HTML" => 8
        "PDF" => 6
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Caso cl&#237;nico</span>"
      "titulo" => "Raquitismo hipofosfat&#233;mico ligado al cromosoma X&#58; diagn&#243;stico en la edad adulta y forma paucisintom&#225;tica"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "116"
          "paginaFinal" => "117"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "X-linked hypophosphatemic rickets&#58; Diagnosis in adult and paucisymptomatic form"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 670
              "Ancho" => 750
              "Tamanyo" => 77049
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Fractura de esc&#225;pula derecha&#46; M&#250;ltiples callos de fractura en &#225;rea costal derecha&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Luis Carlos L&#243;pez-Romero, Jose Jes&#250;s Broseta, Elena Guill&#233;n Olmos, Ram&#243;n Jes&#250;s Devesa-Such, Julio Hern&#225;ndez-Jaras"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Luis Carlos"
              "apellidos" => "L&#243;pez-Romero"
            ]
            1 => array:2 [
              "nombre" => "Jose Jes&#250;s"
              "apellidos" => "Broseta"
            ]
            2 => array:2 [
              "nombre" => "Elena"
              "apellidos" => "Guill&#233;n Olmos"
            ]
            3 => array:2 [
              "nombre" => "Ram&#243;n Jes&#250;s"
              "apellidos" => "Devesa-Such"
            ]
            4 => array:2 [
              "nombre" => "Julio"
              "apellidos" => "Hern&#225;ndez-Jaras"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173574320300204"
        "doi" => "10.1016/j.reumae.2019.07.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574320300204?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X19301214?idApp=UINPBA00004M"
    "url" => "/1699258X/0000001700000002/v2_202107140854/S1699258X19301214/v2_202107140854/es/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>"
    "titulo" => "We might have the same mutation but my inflammasome beats your inflammasome&#58; CINCA versus FCAS"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "118"
        "paginaFinal" => "119"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Mustafa &#199;akan, &#350;erife G&#252;l Karada&#287;, Nuray Aktay Ayaz"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Mustafa"
            "apellidos" => "&#199;akan"
            "email" => array:1 [
              0 => "mustafacakan@hotmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "&#350;erife G&#252;l"
            "apellidos" => "Karada&#287;"
          ]
          2 => array:2 [
            "nombre" => "Nuray Aktay"
            "apellidos" => "Ayaz"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Health Sciences University&#44; Istanbul Kanuni Sultan S&#252;leyman Research and Training Hospital&#44; Clinic of Pediatric Rheumatology&#44; Istanbul&#44; Turkey"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Podr&#237;amos tener la misma mutaci&#243;n&#44; pero mi inflamasoma vence al tuyo&#58; CINCA versus FCAS"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1809
            "Ancho" => 2508
            "Tamanyo" => 487700
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; The view of the arthropathy and rash of CINCA patient&#46; &#40;b&#41; The view of the rash of FCAS patient&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Autoinflammatory diseases are a group of disorders primarily characterized by dysregulation of innate immunity&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> Inflammasomes are complex protein structures that are formed either spontaneously or after a trigger and produce caspase 1&#46; Caspase 1 cleaves pro-IL-1&#946; and pro-IL-18 to IL-1&#946; and IL-18&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1&#44;2</span></a> Cryopyrin-associated periodic fever syndromes &#40;CAPS&#41; are a group of autoinflammatory disorders caused by mutations in the <span class="elsevierStyleItalic">NLRP3</span> gene&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> CAPS comprise three group of disorders&#58; chronic infantile neurological cutaneous and articular syndrome &#40;CINCA&#41;&#44; also known as neonatal-onset multisystem inflammatory disease &#40;NOMID&#41;&#44; Muckle-Wells syndrome &#40;MWS&#41;&#44; and familial cold autoinflammatory syndrome &#40;FCAS&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1&#8211;4</span></a> CINCA is associated with the most severe phenotype in the spectrum of CAPS&#46; The symptoms generally start in early infancy or even at birth&#46; Fever&#44; rash&#44; arthropathy&#44; central nervous system and ocular involvement are the main features of the disease&#46; MWS is associated with moderate severity and characterized by attacks of fever&#44; rash&#44; arthralgia&#44; arthritis and progressive sensorineural hearing loss&#46; FCAS is considered as the least severe phenotype of CAPS and characterized by self-limited episodes of fever&#44; rash&#44; conjunctivitis&#44; and arthralgia lasting less than 24<span class="elsevierStyleHsp" style=""></span>h&#44; precipitated by generalized exposure to cold&#46; Some patients may develop daily rash suggesting chronic inflammation&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a> The significance of V198M sequence variant in the <span class="elsevierStyleItalic">NLRP3</span> gene is uncertain and considered as low penetrant mutation&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">6&#44;7</span></a> Herein we present two cases at the extreme ends of the CAPS spectrum with V198M sequence variant in the <span class="elsevierStyleItalic">NLRP3</span> gene to demonstrate that V198M sequence variant&#44; even though regarded as low penetrant mutation&#44; may cause to CINCA phenotype&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Case 1</span>&#58; A 16-month-old girl was consulted to pediatric rheumatology due to non-remitting fever for 3 weeks and persistence of high acute reactants &#40;APR&#41;&#46; She was born to non-consanguineous healthy parents at 29 weeks of gestation&#44; 820<span class="elsevierStyleHsp" style=""></span>g&#44; and was hospitalized for 3 months postnatally&#46; She had two episodes of persistent unexplained fever&#44; high APR &#91;C-reactive protein &#40;CRP&#41;&#58; 108<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; erythrocyte sedimentation rate &#40;ESR&#41;&#58; 88<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#93; with sterile cultures&#46; She had never been hospitalized after discharge until this event but was followed closely because of prematurity and insufficient physical development&#46; She had three episodes of fever and rash attacks and two episodes of only rash lasting 1&#8211;2 weeks in a year&#46; On physical examination she had frontal bossing&#44; saddle nose&#44; nystagmus&#44; swelling of bilateral knees and ankles &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41; and high APR &#40;CRP&#58; 299<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; ESR&#58; 140<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#41;&#46; Cranial magnetic resonance imaging&#44; eye examinations&#44; and auditory screening tests have been done at the follow-up visits for prematurity and all were normal&#46; After combining the medical history and physical findings we have suspected CINCA and <span class="elsevierStyleItalic">NLRP3</span> analysis showed heterozygous V198M sequence variant in exon 3&#46; Anakinra 2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day was started and APR dramatically improved with resolution of the fever&#46; But after a few months&#44; APR started to increase gradually again without fever and anakinra dose was increased up to 8<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day&#46; Six months later anakinra was switched to canakinumab &#40;2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;month&#41; due to painful injections&#46; Under canakinumab treatment&#44; although at some intervals had APR near to normal levels&#44; inflammation was not controlled totally &#40;CRP&#58; 51<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; ESR&#58; 55<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#41; and dose was increased gradually up to 12<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;month&#46; She is being followed for 3&#46;5 years and currently under monthly canakinumab &#40;12<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;month&#41; injections with normal APR and without further attacks&#46; Neurological development of the patient is compatible with her age&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Case 2</span>&#58; An 8-year-old girl was admitted to clinic with the complaint of non-pruritic rash for the last 9 months&#46; Parents were non-consanguineous and healthy&#46; The rash was waxing and waning spontaneously but sometimes was getting worse with accompanying myalgia&#44; red eyes and subtle fever for a few days&#46; She had been followed and investigated by dermatology and pediatric allergy departments and many anti-histaminic medications have been tried with no effect on the rash&#46; The family did not associate the start of the rash with cold exposure but recalled that she was feeling unwell with more rashes after exposure to cold&#46; She had discrete annular urticaria-like rashes most notable on the forehead and lower extremities &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>b&#41; with normal examination otherwise&#46; APR was mildly elevated &#40;CRP 18<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; ESR&#58; 20<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#41;&#46; The clinical picture of the patient was compatible with FCAS and <span class="elsevierStyleItalic">NLRP3</span> analysis showed heterozygous V198M sequence variant in exon 3&#46; She is currently using canakinumab &#40;2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#41; every two months for the last 3 years and did not have any further attack since the first dose of canakinumab&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In conclusion&#44; although CAPS patients have the same genetic disturbance and pathophysiology&#44; CINCA patients seem to have a continuous activity of inflammasome&#46; Early initiation of treatment with an IL-1 blocker &#40;anakinra&#44; canakinumab or rilonacept&#41; is essential to control ongoing inflammation and prevent secondary amyloidosis in CAPS patient and very high doses of IL-1 blockers may be needed in the very young to control the overwhelming inflammation&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0030" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">There is no conflict of interest associated with the manuscript&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:3 [
        0 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Funding"
        ]
        1 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflict of interest"
        ]
        2 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-07-21"
    "fechaAceptado" => "2019-12-19"
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1809
            "Ancho" => 2508
            "Tamanyo" => 487700
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; The view of the arthropathy and rash of CINCA patient&#46; &#40;b&#41; The view of the rash of FCAS patient&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:7 [
            0 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autoinflammatory diseases&#58; state of the art"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Georgin-Lavialle"
                            1 => "A&#46; Fayand"
                            2 => "F&#46; Rodrigues"
                            3 => "C&#46; Bachmeyer"
                            4 => "L&#46; Savey"
                            5 => "G&#46; Grateau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.lpm.2018.12.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Presse Med"
                        "fecha" => "2019"
                        "volumen" => "48"
                        "paginaInicial" => "e25"
                        "paginaFinal" => "e48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30686513"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An update on autoinflammatory diseases&#58; inflammasomopathies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;R&#46; Harapas"
                            1 => "A&#46; Steiner"
                            2 => "S&#46; Davidson"
                            3 => "S&#46;L&#46; Masters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11926-018-0750-4"
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Rheumatol Rep"
                        "fecha" => "2018"
                        "volumen" => "20"
                        "paginaInicial" => "40"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29846819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of a novel mutation in NLRP3&#47;CIAS1 gene in an Indian child with Neonatal-Onset Multisystem Inflammatory Disease &#40;NOMID&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;B&#46; Nair"
                            1 => "P&#46;P&#46; Chavan"
                            2 => "A&#46;S&#46; Athalye"
                            3 => "I&#46; Aksentijevich"
                            4 => "R&#46;P&#46; Khubchandani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10067-018-4225-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Rheumatol"
                        "fecha" => "2019"
                        "volumen" => "38"
                        "paginaInicial" => "403"
                        "paginaFinal" => "406"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30066283"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Phenotypic and genotypic characteristics of cryopyrin-associated periodic syndrome&#58; a series of 136 patients from the Eurofever registry"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "for PRINTO and Eurofever"
                          "etal" => true
                          "autores" => array:7 [
                            0 => "R&#46; Levy"
                            1 => "L&#46; Gerard"
                            2 => "J&#46; Keummerle-Deschner"
                            3 => "H&#46;J&#46; Lachmann"
                            4 => "I&#46; Kone-Paut"
                            5 => "L&#46; Cantarini"
                            6 => "P&#46; Woo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2013-204991"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2015"
                        "volumen" => "74"
                        "paginaInicial" => "2043"
                        "paginaFinal" => "2049"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25038238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Classification criteria for autoinflammatory recurrent fevers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Gattorno"
                            1 => "M&#46; Hofer"
                            2 => "S&#46; Federici"
                            3 => "F&#46; Vanoni"
                            4 => "F&#46; Bovis"
                            5 => "I&#46; Aksentijevich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2019-215048"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2019"
                        "volumen" => "78"
                        "paginaInicial" => "1025"
                        "paginaFinal" => "1032"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31018962"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0039606013004753"
                          "estado" => "S300"
                          "issn" => "00396060"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and molecular phenotypes of low-penetrance variants of NLRP3&#58; diagnostic and therapeutic challenges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;B&#46; Keummerle-Deschner"
                            1 => "D&#46; Verma"
                            2 => "T&#46; Endres"
                            3 => "L&#46; Broderick"
                            4 => "A&#46;A&#46; de Jesus"
                            5 => "F&#46; Hofer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.40208"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheumatol"
                        "fecha" => "2017"
                        "volumen" => "69"
                        "paginaInicial" => "2233"
                        "paginaFinal" => "2240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28692792"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics in subjects with NLRP3 V198M diagnosed at a single UK center and a review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;M&#46; Rowczenio"
                            1 => "H&#46; Trojer"
                            2 => "T&#46; Russell"
                            3 => "A&#46; Baginska"
                            4 => "T&#46; Lane"
                            5 => "N&#46;M&#46; Stewart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/ar4171"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Res Ther"
                        "fecha" => "2013"
                        "volumen" => "15"
                        "paginaInicial" => "R30"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23421920"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/1699258X/0000001700000002/v2_202107140854/S1699258X20300103/v2_202107140854/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "42683"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Reumatolog&#237;a cl&#237;nica en im&#225;genes"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/1699258X/0000001700000002/v2_202107140854/S1699258X20300103/v2_202107140854/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X20300103?idApp=UINPBA00004M"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Images in Clinical Rheumatology
We might have the same mutation but my inflammasome beats your inflammasome: CINCA versus FCAS
Podríamos tener la misma mutación, pero mi inflamasoma vence al tuyo: CINCA versus FCAS
Mustafa Çakan
Autor para correspondencia
mustafacakan@hotmail.com

Corresponding author.
, Şerife Gül Karadağ, Nuray Aktay Ayaz
Health Sciences University, Istanbul Kanuni Sultan Süleyman Research and Training Hospital, Clinic of Pediatric Rheumatology, Istanbul, Turkey
Leído
2521
Veces
se ha leído el artículo
1145
Total PDF
1376
Total HTML
Compartir estadísticas
 array:23 [
  "pii" => "S1699258X20300103"
  "issn" => "1699258X"
  "doi" => "10.1016/j.reuma.2019.12.002"
  "estado" => "S300"
  "fechaPublicacion" => "2021-02-01"
  "aid" => "1386"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Reumatolog&#237;a y Colegio Mexicano de Reumatolog&#237;a"
  "copyrightAnyo" => "2020"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Reumatol Clin. 2021;17:118-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1699258X19300324"
    "issn" => "1699258X"
    "doi" => "10.1016/j.reuma.2019.01.003"
    "estado" => "S300"
    "fechaPublicacion" => "2021-02-01"
    "aid" => "1321"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Reumatolog&#237;a y Colegio Mexicano de Reumatolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Reumatol Clin. 2021;17:120"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 29
      "formatos" => array:2 [
        "HTML" => 23
        "PDF" => 6
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
      "titulo" => "La distensi&#243;n h&#237;drica en las capsulitis de hombro"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "120"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Hydric distension of shoulder capsulitis"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Moreen Mei&#223;ner, Cayetano Alegre de Miquel"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Moreen"
              "apellidos" => "Mei&#223;ner"
            ]
            1 => array:2 [
              "nombre" => "Cayetano"
              "apellidos" => "Alegre de Miquel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173574321000010"
        "doi" => "10.1016/j.reumae.2019.01.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574321000010?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X19300324?idApp=UINPBA00004M"
    "url" => "/1699258X/0000001700000002/v2_202107140854/S1699258X19300324/v2_202107140854/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1699258X19301214"
    "issn" => "1699258X"
    "doi" => "10.1016/j.reuma.2019.07.007"
    "estado" => "S300"
    "fechaPublicacion" => "2021-02-01"
    "aid" => "1360"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Reumatolog&#237;a y Colegio Mexicano de Reumatolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Reumatol Clin. 2021;17:116-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 14
      "formatos" => array:2 [
        "HTML" => 8
        "PDF" => 6
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Caso cl&#237;nico</span>"
      "titulo" => "Raquitismo hipofosfat&#233;mico ligado al cromosoma X&#58; diagn&#243;stico en la edad adulta y forma paucisintom&#225;tica"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "116"
          "paginaFinal" => "117"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "X-linked hypophosphatemic rickets&#58; Diagnosis in adult and paucisymptomatic form"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 670
              "Ancho" => 750
              "Tamanyo" => 77049
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Fractura de esc&#225;pula derecha&#46; M&#250;ltiples callos de fractura en &#225;rea costal derecha&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Luis Carlos L&#243;pez-Romero, Jose Jes&#250;s Broseta, Elena Guill&#233;n Olmos, Ram&#243;n Jes&#250;s Devesa-Such, Julio Hern&#225;ndez-Jaras"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Luis Carlos"
              "apellidos" => "L&#243;pez-Romero"
            ]
            1 => array:2 [
              "nombre" => "Jose Jes&#250;s"
              "apellidos" => "Broseta"
            ]
            2 => array:2 [
              "nombre" => "Elena"
              "apellidos" => "Guill&#233;n Olmos"
            ]
            3 => array:2 [
              "nombre" => "Ram&#243;n Jes&#250;s"
              "apellidos" => "Devesa-Such"
            ]
            4 => array:2 [
              "nombre" => "Julio"
              "apellidos" => "Hern&#225;ndez-Jaras"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173574320300204"
        "doi" => "10.1016/j.reumae.2019.07.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574320300204?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X19301214?idApp=UINPBA00004M"
    "url" => "/1699258X/0000001700000002/v2_202107140854/S1699258X19301214/v2_202107140854/es/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>"
    "titulo" => "We might have the same mutation but my inflammasome beats your inflammasome&#58; CINCA versus FCAS"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "118"
        "paginaFinal" => "119"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Mustafa &#199;akan, &#350;erife G&#252;l Karada&#287;, Nuray Aktay Ayaz"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Mustafa"
            "apellidos" => "&#199;akan"
            "email" => array:1 [
              0 => "mustafacakan@hotmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "&#350;erife G&#252;l"
            "apellidos" => "Karada&#287;"
          ]
          2 => array:2 [
            "nombre" => "Nuray Aktay"
            "apellidos" => "Ayaz"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Health Sciences University&#44; Istanbul Kanuni Sultan S&#252;leyman Research and Training Hospital&#44; Clinic of Pediatric Rheumatology&#44; Istanbul&#44; Turkey"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Podr&#237;amos tener la misma mutaci&#243;n&#44; pero mi inflamasoma vence al tuyo&#58; CINCA versus FCAS"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1809
            "Ancho" => 2508
            "Tamanyo" => 487700
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; The view of the arthropathy and rash of CINCA patient&#46; &#40;b&#41; The view of the rash of FCAS patient&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Autoinflammatory diseases are a group of disorders primarily characterized by dysregulation of innate immunity&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> Inflammasomes are complex protein structures that are formed either spontaneously or after a trigger and produce caspase 1&#46; Caspase 1 cleaves pro-IL-1&#946; and pro-IL-18 to IL-1&#946; and IL-18&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1&#44;2</span></a> Cryopyrin-associated periodic fever syndromes &#40;CAPS&#41; are a group of autoinflammatory disorders caused by mutations in the <span class="elsevierStyleItalic">NLRP3</span> gene&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> CAPS comprise three group of disorders&#58; chronic infantile neurological cutaneous and articular syndrome &#40;CINCA&#41;&#44; also known as neonatal-onset multisystem inflammatory disease &#40;NOMID&#41;&#44; Muckle-Wells syndrome &#40;MWS&#41;&#44; and familial cold autoinflammatory syndrome &#40;FCAS&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1&#8211;4</span></a> CINCA is associated with the most severe phenotype in the spectrum of CAPS&#46; The symptoms generally start in early infancy or even at birth&#46; Fever&#44; rash&#44; arthropathy&#44; central nervous system and ocular involvement are the main features of the disease&#46; MWS is associated with moderate severity and characterized by attacks of fever&#44; rash&#44; arthralgia&#44; arthritis and progressive sensorineural hearing loss&#46; FCAS is considered as the least severe phenotype of CAPS and characterized by self-limited episodes of fever&#44; rash&#44; conjunctivitis&#44; and arthralgia lasting less than 24<span class="elsevierStyleHsp" style=""></span>h&#44; precipitated by generalized exposure to cold&#46; Some patients may develop daily rash suggesting chronic inflammation&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a> The significance of V198M sequence variant in the <span class="elsevierStyleItalic">NLRP3</span> gene is uncertain and considered as low penetrant mutation&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">6&#44;7</span></a> Herein we present two cases at the extreme ends of the CAPS spectrum with V198M sequence variant in the <span class="elsevierStyleItalic">NLRP3</span> gene to demonstrate that V198M sequence variant&#44; even though regarded as low penetrant mutation&#44; may cause to CINCA phenotype&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Case 1</span>&#58; A 16-month-old girl was consulted to pediatric rheumatology due to non-remitting fever for 3 weeks and persistence of high acute reactants &#40;APR&#41;&#46; She was born to non-consanguineous healthy parents at 29 weeks of gestation&#44; 820<span class="elsevierStyleHsp" style=""></span>g&#44; and was hospitalized for 3 months postnatally&#46; She had two episodes of persistent unexplained fever&#44; high APR &#91;C-reactive protein &#40;CRP&#41;&#58; 108<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; erythrocyte sedimentation rate &#40;ESR&#41;&#58; 88<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#93; with sterile cultures&#46; She had never been hospitalized after discharge until this event but was followed closely because of prematurity and insufficient physical development&#46; She had three episodes of fever and rash attacks and two episodes of only rash lasting 1&#8211;2 weeks in a year&#46; On physical examination she had frontal bossing&#44; saddle nose&#44; nystagmus&#44; swelling of bilateral knees and ankles &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41; and high APR &#40;CRP&#58; 299<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; ESR&#58; 140<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#41;&#46; Cranial magnetic resonance imaging&#44; eye examinations&#44; and auditory screening tests have been done at the follow-up visits for prematurity and all were normal&#46; After combining the medical history and physical findings we have suspected CINCA and <span class="elsevierStyleItalic">NLRP3</span> analysis showed heterozygous V198M sequence variant in exon 3&#46; Anakinra 2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day was started and APR dramatically improved with resolution of the fever&#46; But after a few months&#44; APR started to increase gradually again without fever and anakinra dose was increased up to 8<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day&#46; Six months later anakinra was switched to canakinumab &#40;2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;month&#41; due to painful injections&#46; Under canakinumab treatment&#44; although at some intervals had APR near to normal levels&#44; inflammation was not controlled totally &#40;CRP&#58; 51<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; ESR&#58; 55<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#41; and dose was increased gradually up to 12<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;month&#46; She is being followed for 3&#46;5 years and currently under monthly canakinumab &#40;12<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;month&#41; injections with normal APR and without further attacks&#46; Neurological development of the patient is compatible with her age&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Case 2</span>&#58; An 8-year-old girl was admitted to clinic with the complaint of non-pruritic rash for the last 9 months&#46; Parents were non-consanguineous and healthy&#46; The rash was waxing and waning spontaneously but sometimes was getting worse with accompanying myalgia&#44; red eyes and subtle fever for a few days&#46; She had been followed and investigated by dermatology and pediatric allergy departments and many anti-histaminic medications have been tried with no effect on the rash&#46; The family did not associate the start of the rash with cold exposure but recalled that she was feeling unwell with more rashes after exposure to cold&#46; She had discrete annular urticaria-like rashes most notable on the forehead and lower extremities &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>b&#41; with normal examination otherwise&#46; APR was mildly elevated &#40;CRP 18<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; ESR&#58; 20<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#41;&#46; The clinical picture of the patient was compatible with FCAS and <span class="elsevierStyleItalic">NLRP3</span> analysis showed heterozygous V198M sequence variant in exon 3&#46; She is currently using canakinumab &#40;2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#41; every two months for the last 3 years and did not have any further attack since the first dose of canakinumab&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In conclusion&#44; although CAPS patients have the same genetic disturbance and pathophysiology&#44; CINCA patients seem to have a continuous activity of inflammasome&#46; Early initiation of treatment with an IL-1 blocker &#40;anakinra&#44; canakinumab or rilonacept&#41; is essential to control ongoing inflammation and prevent secondary amyloidosis in CAPS patient and very high doses of IL-1 blockers may be needed in the very young to control the overwhelming inflammation&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0030" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">There is no conflict of interest associated with the manuscript&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:3 [
        0 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Funding"
        ]
        1 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflict of interest"
        ]
        2 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-07-21"
    "fechaAceptado" => "2019-12-19"
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1809
            "Ancho" => 2508
            "Tamanyo" => 487700
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; The view of the arthropathy and rash of CINCA patient&#46; &#40;b&#41; The view of the rash of FCAS patient&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:7 [
            0 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autoinflammatory diseases&#58; state of the art"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Georgin-Lavialle"
                            1 => "A&#46; Fayand"
                            2 => "F&#46; Rodrigues"
                            3 => "C&#46; Bachmeyer"
                            4 => "L&#46; Savey"
                            5 => "G&#46; Grateau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.lpm.2018.12.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Presse Med"
                        "fecha" => "2019"
                        "volumen" => "48"
                        "paginaInicial" => "e25"
                        "paginaFinal" => "e48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30686513"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An update on autoinflammatory diseases&#58; inflammasomopathies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;R&#46; Harapas"
                            1 => "A&#46; Steiner"
                            2 => "S&#46; Davidson"
                            3 => "S&#46;L&#46; Masters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11926-018-0750-4"
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Rheumatol Rep"
                        "fecha" => "2018"
                        "volumen" => "20"
                        "paginaInicial" => "40"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29846819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of a novel mutation in NLRP3&#47;CIAS1 gene in an Indian child with Neonatal-Onset Multisystem Inflammatory Disease &#40;NOMID&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;B&#46; Nair"
                            1 => "P&#46;P&#46; Chavan"
                            2 => "A&#46;S&#46; Athalye"
                            3 => "I&#46; Aksentijevich"
                            4 => "R&#46;P&#46; Khubchandani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10067-018-4225-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Rheumatol"
                        "fecha" => "2019"
                        "volumen" => "38"
                        "paginaInicial" => "403"
                        "paginaFinal" => "406"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30066283"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Phenotypic and genotypic characteristics of cryopyrin-associated periodic syndrome&#58; a series of 136 patients from the Eurofever registry"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "for PRINTO and Eurofever"
                          "etal" => true
                          "autores" => array:7 [
                            0 => "R&#46; Levy"
                            1 => "L&#46; Gerard"
                            2 => "J&#46; Keummerle-Deschner"
                            3 => "H&#46;J&#46; Lachmann"
                            4 => "I&#46; Kone-Paut"
                            5 => "L&#46; Cantarini"
                            6 => "P&#46; Woo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2013-204991"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2015"
                        "volumen" => "74"
                        "paginaInicial" => "2043"
                        "paginaFinal" => "2049"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25038238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Classification criteria for autoinflammatory recurrent fevers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Gattorno"
                            1 => "M&#46; Hofer"
                            2 => "S&#46; Federici"
                            3 => "F&#46; Vanoni"
                            4 => "F&#46; Bovis"
                            5 => "I&#46; Aksentijevich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2019-215048"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2019"
                        "volumen" => "78"
                        "paginaInicial" => "1025"
                        "paginaFinal" => "1032"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31018962"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0039606013004753"
                          "estado" => "S300"
                          "issn" => "00396060"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and molecular phenotypes of low-penetrance variants of NLRP3&#58; diagnostic and therapeutic challenges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;B&#46; Keummerle-Deschner"
                            1 => "D&#46; Verma"
                            2 => "T&#46; Endres"
                            3 => "L&#46; Broderick"
                            4 => "A&#46;A&#46; de Jesus"
                            5 => "F&#46; Hofer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.40208"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheumatol"
                        "fecha" => "2017"
                        "volumen" => "69"
                        "paginaInicial" => "2233"
                        "paginaFinal" => "2240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28692792"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics in subjects with NLRP3 V198M diagnosed at a single UK center and a review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;M&#46; Rowczenio"
                            1 => "H&#46; Trojer"
                            2 => "T&#46; Russell"
                            3 => "A&#46; Baginska"
                            4 => "T&#46; Lane"
                            5 => "N&#46;M&#46; Stewart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/ar4171"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Res Ther"
                        "fecha" => "2013"
                        "volumen" => "15"
                        "paginaInicial" => "R30"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23421920"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/1699258X/0000001700000002/v2_202107140854/S1699258X20300103/v2_202107140854/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "42683"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Reumatolog&#237;a cl&#237;nica en im&#225;genes"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/1699258X/0000001700000002/v2_202107140854/S1699258X20300103/v2_202107140854/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X20300103?idApp=UINPBA00004M"
]
Información del artículo
ISSN: 1699258X
Idioma original: Inglés
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 9 12 21
2024 Octubre 25 22 47
2024 Septiembre 20 15 35
2024 Agosto 47 31 78
2024 Julio 38 30 68
2024 Junio 40 59 99
2024 Mayo 50 36 86
2024 Abril 42 27 69
2024 Marzo 44 27 71
2024 Febrero 36 19 55
2024 Enero 20 16 36
2023 Diciembre 19 23 42
2023 Noviembre 21 22 43
2023 Octubre 29 28 57
2023 Septiembre 61 40 101
2023 Agosto 34 16 50
2023 Julio 34 23 57
2023 Junio 35 17 52
2023 Mayo 39 24 63
2023 Abril 29 9 38
2023 Marzo 33 25 58
2023 Febrero 43 26 69
2023 Enero 31 16 47
2022 Diciembre 46 22 68
2022 Noviembre 40 30 70
2022 Octubre 41 32 73
2022 Septiembre 38 26 64
2022 Agosto 37 37 74
2022 Julio 30 36 66
2022 Junio 37 30 67
2022 Mayo 36 43 79
2022 Abril 43 34 77
2022 Marzo 32 36 68
2022 Febrero 29 22 51
2022 Enero 28 31 59
2021 Diciembre 21 39 60
2021 Noviembre 29 39 68
2021 Octubre 45 48 93
2021 Septiembre 33 37 70
2021 Agosto 24 32 56
2021 Julio 1 0 1
2021 Mayo 1 0 1
2021 Marzo 0 2 2
2021 Febrero 3 4 7
2020 Noviembre 1 0 1
2020 Junio 1 2 3
2020 Mayo 1 0 1
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Reumatología Clínica
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?