Autoinflammatory gene mutations associated with eosinophilia and asthma.

Bashayr M Alotaibi, Raquel Lopez Rodriguez, Carmen Venegas Garrido, Lucia Gonzalez Bravo, Nader Khalidi, Parameswaran Nair
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Abstract

Background: Respiratory conditions, such as asthma, are infrequently associated with auto-inflammatory diseases. We describe five patients with uncontrolled respiratory symptoms that were seen at St. Joesph's Healthcare in Hamilton for severe asthma management diagnosed with rare autoinflammatory conditions using genetic molecular analysis.

Case presentation: Five patients are included in this case series. Gene mutations associated with familial Mediterranean fever, Yao syndrome, Cryopyrin-associated periodic syndrome, and Majeed syndrome were considered to explain partly the patient's clinical manifestation after comprehensive clinical, biochemical, hematological investigations ruled out other disorders such as parasitosis, Allergic Bronchopulmonary Fungosis, Eosinophilic Granulomatosis with Poly Angitis, IgG4 disease, and Hypereosinophilia syndrome.

Conclusions: Complex patients initially presenting with respiratory conditions in addition to unexplained autoinflammatory conditions are a diagnostic challenge. Genetic molecular testing provides healthcare practitioners with useful information that may diagnose underlying auto-inflammatory diseases in undifferentiated patients. Role of inflammasome-activation in asthma and eosinophilia needs further investigation.

Abstract Image

嗜酸性粒细胞增多和哮喘相关的自身炎症基因突变。
背景:呼吸系统疾病,如哮喘,很少与自身炎症性疾病相关。我们描述了在汉密尔顿的St. joseph 's Healthcare就诊的5例呼吸系统症状不受控制的患者,他们因严重哮喘管理而被诊断为罕见的自身炎症,使用遗传分子分析。病例介绍:本病例系列包括5例患者。经综合临床、生化、血液学调查,排除了寄生虫病、过敏性支气管肺真菌病、嗜酸性肉芽肿病合并多血管炎、IgG4病、嗜酸性粒细胞增多综合征等其他疾病,认为家族性地中海热、姚综合征、冷冻蛋白相关周期综合征、马吉德综合征等相关基因突变部分解释了患者的临床表现。结论:复杂的患者最初表现为呼吸系统疾病和不明原因的自身炎症是一个诊断挑战。基因分子检测为医疗保健从业者提供了有用的信息,可以在未分化的患者中诊断潜在的自身炎性疾病。炎症小体活化在哮喘和嗜酸性粒细胞增多症中的作用有待进一步研究。
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