Cryopyrin-Associated Periodic Syndromes: Otolaryngologic and Audiologic Manifestations

被引:66
作者
Ahmadi, Neda
Brewer, Carmen C. [2 ]
Zalewski, Christopher [2 ]
King, Kelly A. [2 ]
Butman, John A. [3 ]
Plass, Nicole [4 ]
Henderson, Cailin [4 ]
Goldbach-Mansky, Raphaela [4 ]
Kim, H. Jeffrey [1 ,2 ]
机构
[1] Georgetown Univ Hosp, Dept Otolaryngol HNS, Washington, DC 20007 USA
[2] Natl Inst Deafness & Other Communicat Disorders, NIH, Bethesda, MD USA
[3] NIH, NIH Clin Ctr, Bethesda, MD 20892 USA
[4] NIAMSD, NIH, Bethesda, MD 20892 USA
关键词
cryopyrin-associated periodic syndromes; familial cold auto-inflammatory syndrome; Muckle-Wells syndrome; neonatalonset multisystem inflammatory disease; chronic infantile neurological cutaneous and articular syndrome; COLD AUTOINFLAMMATORY SYNDROME; MUCKLE-WELLS-SYNDROME; CIAS1; MUTATIONS; DISEASES; INFLAMMATION; PATHOGENESIS; INHIBITION; ANAKINRA; SPECTRUM; FEATURES;
D O I
10.1177/0194599811402296
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective. Cryopyrin-associated periodic syndromes (CAPS) represent a spectrum of CIAS1 gene-mediated autoinflammatory diseases characterized by recurrent systemic inflammation. The clinical spectrum of CAPS varies from mild to severe and includes the syndromes historically described as familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (NOMID). This article presents the largest cohort of patients with CAPS. The objective is to describe the pathogenesis, otolaryngologic, and audiologic manifestations of CAPS. Study Design. Prospective (2003-2009). Setting. National Institutes of Health. Subjects and Methods. Fifty-seven patients with a diagnosis of CAPS were identified (31 NOMID, 11 NOMID/MWS, 9 MWS, and 6 FCAS). Comprehensive data regarding clinical manifestations, audiologic phenotype, and fluid attenuation inversion recovery MRI (FLAIR-MRI) of the brain and inner ear were obtained. Results. Complete audiologic data obtained on 70% of ears revealed conductive hearing loss in 4 (11%) NOMID ears and mixed hearing loss in 5 (13%) NOMID and 2 (14%) NOMID/MWS ears. Sensorineural hearing loss (SNHL), worse in higher frequencies, was the most common type of hearing loss and was present in 23 (61%) NOMID, 10 (71%) NOMID/MWS, and 4 (33%) MWS ears. All of the patients with FCAS had normal hearing except 2, who had SNHL from 4 to 8 kHz. On FLAIR-MRI sequence, cochlear enhancement was noted in 26 of 29 (90%) NOMID, 6 of 11 (55%) NOMID/MWS, 3 of 9 (33%) MWS, and 1 of 6 (17%) FCAS patients and was significantly associated with the presence of hearing loss. Maxillary sinus hypoplasia and mucosal thickening were found in 39% and 86% of the cohort, respectively. Conclusion. CIAS1 pathway-mediated CAPS is associated with unregulated autoinflammation mediated by interleukin-1 in the cochlea and hearing loss. Timely diagnosis is crucial to initiate early treatment with interleukin-1 receptor antagonists.
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页码:295 / 302
页数:8
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