Magnetic resonance imaging findings in a patient with cryopyrin-associated periodic syndrome: A rare hereditary multi-system inflammatory disorder

Neuroradiol J. 2019 Dec;32(6):420-425. doi: 10.1177/1971400919863712. Epub 2019 Jul 24.

Abstract

Cryopyrin-associated periodic syndrome is a hereditary inflammatory disorder encompassing a wide spectrum of clinical phenotypes. This disorder has been associated with mutation of the NLRP3 gene coding for cryopyrin, which leads to overproduction of interleukin-1. The condition causes relapsing bouts of inflammation involving multiple organ systems, including the central nervous system, and, if untreated, can lead to long-term debilitating effects. A literature review revealed only a few brief descriptions of magnetic resonance imaging findings in cryopyrin-associated periodic syndrome patients. We describe serial magnetic resonance imaging findings in an 11-year-old female with clinically diagnosed cryopyrin-associated periodic syndrome who presented with intermittent headaches, progressive sensorineural hearing loss, fevers, and abdominal pain. The magnetic resonance imaging showed progressively worsening low T2 signal in the cochlea, cochlear enhancement, and leptomeningeal enhancement. We also describe some previously unreported findings in this syndrome, including cranial nerve and cauda equina enhancement.

Keywords: CAPS; cryopyrin-associated periodic syndrome; inflammatory disorder.

Publication types

  • Case Reports

MeSH terms

  • Arnold-Chiari Malformation / complications
  • Arnold-Chiari Malformation / diagnostic imaging
  • Brain / diagnostic imaging
  • Cauda Equina / diagnostic imaging*
  • Central Nervous System / diagnostic imaging*
  • Child
  • Cochlea / diagnostic imaging*
  • Cranial Nerves / diagnostic imaging*
  • Cryopyrin-Associated Periodic Syndromes / complications
  • Cryopyrin-Associated Periodic Syndromes / diagnostic imaging*
  • Disease Progression
  • Female
  • Hearing Loss, Sensorineural / complications
  • Hearing Loss, Sensorineural / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging
  • Meninges / diagnostic imaging
  • Spinal Cord / diagnostic imaging