Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Clinical and Genetic Features of Autoinflammatory Syndromes in Hispanic Patients: The Chilean Experience.
Vergara1, Cristian, Borzutzky1, Arturo, Gutierrez1, Miguel A., Iacobelli1, Sergio, Talesnik1, Eduardo, Martinez1, Maria Eugenia, Stange1, Lilith
Pontificia Universidad Catolica de Chile, Santiago, Chile
Universidad de Chile, Santiago, Chile
Hospital FACH, Santiago, Chile
Hospital Gustavo Fricke, Valparaiso, Chile
Hospital Naval Almirante Nef, Vina Del Mar, Chile
Hospital Militar, Santiago, Chile
Hospital Clínic/IDIBAPS, Barcelona, Spain
Hereditary autoinflammatory syndromes (AIS) are rare genetic diseases characterized by recurrent episodes of inflammation. Little information is available concerning AIS in Latin American Hispanic population. The purpose of this study was to determine the clinical and genetic characteristics of AIS in Chilean population.
A multicenter retrospective study of Hispanic patients from Chile with genetically-confirmed AIS was performed. Inclusion criteria for Familial Mediterranean Fever (FMF) were the presence of the characteristic clinical features associated with at least one mutated MEFV allele, whereas the TNF receptor-associated periodic syndrome (TRAPS) inclusion criteria were the presence of long inflammatory episodes associated with TNFRSF1A mutations. We included 13 patients, eight with FMF and five with TRAPS, evaluated at rheumatology or pediatric rheumatology clinics between January of 2007 and December of 2010. No patients with other AIS were seen in the study period.
All 13 patients were Chilean and had Hispanic Latin American ethnicity with no other known genetic backgrounds. Median age of onset of clinical symptoms was 8 years (range: 135) and 8 years (range: 0.321) for FMF and TRAPS, respectively. Median duration of fever was 3 days (range: 2.515) for FMF and 21 days (range: 9.530) for TRAPS. In FMF patients, fever was associated with abdominal pain (6/8), myalgias (5/8), arthritis (4/8), and rash (3/8). All FMF patients had at least partial response to colchicine therapy, with two patients fully resolving episodes of recurrent fevers. Reactive AA-type amyloidosis was not observed among this group of FMF patients. In TRAPS patients, febrile episodes were preceded by malaise and periorbital edema in two patients. During episodes symptoms accompanying fever were migratory myalgias (4/5), rash (3/5), arthralgias/arthritis (3/5), and abdominal pain (3/5). Two patients with TRAPS underwent surgery for acute abdomen. Fever episodes were responsive to high-dose corticosteroids in 4/5 patients with TRAPS. Genotyping of the MEFV gene in FMF patients revealed one patient with a homozygous M694V missense mutation, and heterozygous missense mutations in seven patients: M694V (n=3), E148Q, R717H, A744S, and A511V. Sequencing of the TNFRSF1A gene in TRAPS patients revealed heterozygous missense mutations in four patients: T50M, C30R, R92Q, and IVS3+30:G>A, and a 2-base pair deletion (IVS217_18del2bpCT) in one patient. Mutation in MEFV R717H and mutations in TNFRSF1A IVS217_18del2bpCT and IVS3+30:G>A are novel and have not been reported previously.
This study reports the largest series of genetically-confirmed AIS in Latin America, and adds evidence regarding the clinical and genetic characteristics of patients with FMF and TRAPS in Hispanic population. In this series, mutations identified in MEFV and TNFRSF1A genes include defects reported in other ethnicities and novel mutations.
To cite this abstract, please use the following information:
Vergara, Cristian, Borzutzky, Arturo, Gutierrez, Miguel A., Iacobelli, Sergio, Talesnik, Eduardo, Martinez, Maria Eugenia, et al; Clinical and Genetic Features of Autoinflammatory Syndromes in Hispanic Patients: The Chilean Experience. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1963