A taste of periodic fever syndromes

Pediatr Emerg Care. 2013 Jul;29(7):842-8; quiz 849-51. doi: 10.1097/PEC.0b013e318298df8b.

Abstract

Periodic fevers are acquired or inherited disorders of innate immunity, which were first described in the 1940s. The patients are typically young at onset and have regularly recurring fevers for a few days to a few weeks with systemic inflammatory symptoms that are interrupted by symptom-free periods. There is a variety of clinical manifestations including gastrointestinal complaints, myalgias, arthralgias, and rash. A differential diagnosis in these patients may include recurrent infections, other inflammatory disorders, and neoplastic disease. This clinical review focuses on a sample of autoinflammatory disorders including familial Mediterranean fever, tumor necrosis factor receptor 1-associated periodic syndrome, hyperimmunoglobulinemia D syndrome, the cryopyrin-associated periodic syndrome, and periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome. We review the basics, pertinent clinical and laboratory features, and management of each entity.

Publication types

  • Review

MeSH terms

  • Amyloidosis / etiology
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Carrier Proteins / genetics
  • Colchicine / therapeutic use
  • Cold Temperature / adverse effects
  • Cryopyrin-Associated Periodic Syndromes / blood
  • Cryopyrin-Associated Periodic Syndromes / diagnosis
  • Cryopyrin-Associated Periodic Syndromes / genetics
  • Emergencies
  • Etanercept
  • Familial Mediterranean Fever / blood
  • Familial Mediterranean Fever / diagnosis
  • Familial Mediterranean Fever / drug therapy
  • Familial Mediterranean Fever / genetics
  • Fever / classification
  • Fever / diagnosis*
  • Fever / genetics
  • Hereditary Autoinflammatory Diseases / blood
  • Hereditary Autoinflammatory Diseases / diagnosis
  • Hereditary Autoinflammatory Diseases / drug therapy
  • Hereditary Autoinflammatory Diseases / genetics
  • Humans
  • Immunoglobulin G / therapeutic use
  • Lymphadenitis / etiology
  • Mevalonate Kinase Deficiency / blood
  • Mevalonate Kinase Deficiency / diagnosis
  • Mevalonate Kinase Deficiency / genetics
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • Periodicity*
  • Pharyngitis / etiology
  • Prednisone / therapeutic use
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Receptors, Tumor Necrosis Factor, Type I / genetics
  • Stomatitis, Aphthous / etiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Carrier Proteins
  • Immunoglobulin G
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • NLRP3 protein, human
  • Receptors, Tumor Necrosis Factor
  • Receptors, Tumor Necrosis Factor, Type I
  • Etanercept
  • Colchicine
  • Prednisone

Supplementary concepts

  • Periodic fever, familial, autosomal dominant