冷冻素相关周期综合征(Muckle-Wells 综合征)和系统性红斑狼疮患者的临床病例

V. Reshkova, Simeon Monov
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摘要

Muckle-Wells 综合征是一种与冰冻蛋白相关的周期性综合征,具有常染色体显性遗传模式。该病的特点是发作性阶梯状移动。我们在临床上发现了一例 34 岁女性冰冻蛋白相关周期性综合征(Muckle-Wells 综合征)和系统性红斑狼疮(SLE)患者。患者是 NLRP3 基因第 3 外显子 3 核苷酸重复(c.1315_1317dupGCG)的杂合子携带者,在第 439 和 440 位氨基酸之间插入了一个丙氨酸(p.Ala439dup)。这种突变是 Muckle-wells 综合征的特征。从临床检查来看,她有中度活动性系统性红斑狼疮的临床症状(SLEDAI=9分)("腋下皮疹"、关节炎、白细胞减少伴淋巴细胞减少、ANA抗体和抗dsDNA抗体水平升高)。患者接受了甲基强的松龙治疗,每天 12 毫克,甲氨蝶呤每周 15 毫克,秋水仙素每天 2 次,每次 0.5 毫克。3 个月来,患者的症状得到了部分改善,但没有完全减轻。目前,患者居住在德国,接受 Anakinra 治疗,效果非常好,生活质量也很高。在文献中没有发现其他与低温霉素相关周期性综合征(Muckle-Wells 综合征)和结缔组织病有关的病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical case of patient with Cryopyrin-associated Periodic Syndrome (Muckle-Wells syndrome) and systemic lupus erhythematodes
Muckle-Wells syndrome is a cryopyrin-associated periodic syndrome with an autosomal dominant transmission pattern. The disease characterized by episodes of step move. We present a clinical case a woman of 34-years old with cryopyrin-associated periodic syndrome (Muckle-Wells syndrome) and systemic lupus erhythematodes (SLE). Patient is a heterozygous carrier of a 3-nucleotide duplication in exon 3 of the NLRP3 gene (c.1315_1317dupGCG), inserting an alanine between amino acid positions 439 and 440 (p.Ala439dup). This mutation is a characteristic with Muckle-wells syndrome. From the clinical examination she has clinical symptoms of SLE with moderate activity from SLEDAI = 9 points (“malar rash”, arthritis, leucopenia with lymphopenia, elevated levels of ANA-antibodys and anti-dsDNA-antibodys). Patient was treatment with methylprednisolone 12 mg daily, methotrexate 15 mg weekly, colchicin 2 time of 0,5 mg daily. Over 3 months patient has partial improvement  of symptoms without full reduction. On the moment patient lives in Germany and has treatment with Anakinra with excellent results and good quality of life. In the literature is not found other with connection between cryopyrin-associated periodic syndrome (Muckle-Wells syndrome) and connective tissue disease.
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