{Reference Type}: Journal Article
{Title}: A unique presentation of NLRP3-associated autoinflammatory disease: case report.
{Author}: Ducharme-Bénard S;Roberge G;Chapdelaine H;
{Journal}: BMC Rheumatol
{Volume}: 6
{Issue}: 1
{Year}: Dec 2022 12
暂无{DOI}: 10.1186/s41927-022-00321-8
{Abstract}: <B>BACKGROUND: </B>NLRP3-associated autoinflammatory diseases (NLRP3-AID) are rare genetic autoinflammatory diseases characterized by chronic inflammation and an urticaria-like rash. We report an unusual presentation of severe NLRP3-AID resulting in a significant diagnostic delay of more than three decades.<BR><B>METHODS: </B>The patient presented with early-onset serositis as well as prominent peripheral eosinophilia with organ infiltration, in the absence of the classic urticaria-like rash. DNA analysis by next generation sequencing revealed a sporadic class 4 mutation c.1991T > C (p.Met662Thr) in the NLRP3 gene, confirming a diagnosis of NLRP3-AID at 36 years old. Although treatment with anti-interleukin 1 agent led to clinical remission, irreversible sequelae, namely intellectual disability and deafness, remained.<BR><B>CONCLUSIONS: </B>This case highlights unique manifestations of NLRP3-AID, namely the absence of urticaria-like rash, eosinophilic organ infiltration, and pseudoseptic serositis. In order to avoid diagnostic delay and its dire consequences, NLRP3-AID should be suspected in patients displaying autoinflammatory features combined with serum and tissue eosinophilia and/or marked serositis, regardless of skin involvement.