Systemic and organ involvement in monogenic autoinflammatory disorders: a global review filtered through internists' lens

Intern Emerg Med. 2016 Sep;11(6):781-91. doi: 10.1007/s11739-016-1466-y. Epub 2016 May 25.

Abstract

Monogenic autoinflammatory disorders (AIDs) are rare diseases driven by cytokine-mediated extraordinary sterile inflammation that results from the activation of innate immune pathways. The clinical hallmark of these diseases is the recurrence of stereotyped episodes of systemic- and organ-specific inflammation; the most common systems involved being the skin, musculoskeletal system, gastrointestinal tract, and central nervous system. The autoinflammatory disorders may have a profound impact on the quality of life of the affected patients, and a delayed diagnosis may lead to severe complications, the most dreadful of which is AA-Amyloidosis. This review gives an overview on the four main AIDs, namely familial Mediterranean fever, tumor necrosis factor receptor-associated periodic syndrome, cryopyrinopathies, and mevalonate kinase deficiency, focusing on their clinical phenotype in adults and differential diagnosis, suggesting a diagnostic algorithm, and reviewing the available treatments.

Keywords: Anakinra; Autoinflammatory disorders; Canakinumab; Hereditary periodic fever syndromes.

Publication types

  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / diagnosis
  • Acquired Immunodeficiency Syndrome / physiopathology
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / physiopathology*
  • Cryopyrin-Associated Periodic Syndromes / diagnosis
  • Cryopyrin-Associated Periodic Syndromes / physiopathology
  • Education, Medical, Continuing / methods*
  • Familial Mediterranean Fever / diagnosis
  • Familial Mediterranean Fever / physiopathology
  • Fever / diagnosis
  • Fever / physiopathology
  • Hereditary Autoinflammatory Diseases / diagnosis
  • Hereditary Autoinflammatory Diseases / physiopathology
  • Humans
  • Internal Medicine / methods
  • Internal Medicine / standards
  • Mevalonate Kinase Deficiency / diagnosis
  • Mevalonate Kinase Deficiency / physiopathology

Supplementary concepts

  • Periodic fever, familial, autosomal dominant