Skip to main content
Log in

Muckle-Wells syndrome in Chinese patients: a single center case series

  • Case Based Review
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Muckle-Wells syndrome (MWS) is a rare autoinflammatory disease. This study aimed to report the clinical features and gene variations of the first case series of MWS patients in Chinese population. Four Han Chinese patients were diagnosed with MWS and followed up at our adult clinic for autoinflammatory diseases. All relevant phenotypes and genotypes were collected. All patients were adult male. The median age of disease onset was 4.5 years, and one patient had adult-onset disease. No positive family history was observed. All patients had a remittent disease course. The duration of fever attacks ranged from 0.5 to 7 days. Skin rashes were present in all patients. The other manifestations included polyarthralgia/arthritis (n = 3), oral ulcers (n = 2), conjunctivitis (n = 2), myalgia (n = 2), headache (n = 2), pharyngitis (n = 1), abdominal pain (n = 1), severe sensorineural hearing loss (n = 1), and chronic meningitis with communicating hydrocephalus (n = 1). None of the patients showed evidence of renal amyloidosis. Each patient carried a heterozygous mutation in an NLRP3 gene, including D29V, V70M, T348M, and Q703K, respectively. D29V and V70M variants were novel mutations in exon 1 of NLRP3. All patients had good response to corticosteroids. Our study suggests that MWS could be identified in Chinese population. Our finding of novel mutations in NLRP3 may expand the diversity of MWS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Hawkins PN, Lachmann HJ, Aganna E, McDermott MF (2004) Spectrum of clinical features in Muckle-Wells syndrome and response to anakinra. Arthritis Rheum 50:607–612

    Article  CAS  PubMed  Google Scholar 

  2. Kümmerle-Deschner JB, Tyrrell PN, Reess F, Kötter I, Lohse P, Girschick H et al (2010) Risk factors for severe Muckle-Wells syndrome. Arthritis Rheum 62(12):3783–3791

    Article  PubMed  Google Scholar 

  3. Nakagawa K, Gonzalez-Roca E, Souto A, Kawai T, Umebayashi H, Campistol JM et al (2015) Somatic NLRP3 mosaicism in Muckle-Wells syndrome. A genetic mechanism shared by different phenotypes of cryopyrin-associated periodic syndromes. Ann Rheum Dis 74:603–610

    Article  CAS  PubMed  Google Scholar 

  4. Levy R, Gérard L, Kuemmerle-Deschner J, Lachmann HJ, Koné-Paut I, Cantarini L et al (2015) Phenotypic and genotypic characteristics of cryopyrin-associated periodic syndrome: a series of 136 patients from the Eurofever Registry. Ann Rheum Dis 74:2043–2049

    Article  CAS  PubMed  Google Scholar 

  5. Kuemmerle-Deschner JB, Dembi SS, Tyrrell PN, Koné-Paut I, Marie I, Deschner N et al (2014) Challenges in diagnosing Muckle-Wells syndrome: identifying two distinct phenotypes. Arthritis Care Res (Hoboken) 66:765–772

    Article  Google Scholar 

  6. Kuemmerle-Deschner JB, Koitschev A, Ummenhofer K, Hansmann S, Plontke SK, Koitschev C et al (2013) Hearing loss in Muckle-Wells syndrome. Arthritis Rheum 65:824–831

    Article  CAS  PubMed  Google Scholar 

  7. Kuemmerle-Deschner JB, Tyrrell PN, Koetter I, Wittkowski H, Bialkowski A, Tzaribachev N et al (2011) Efficacy and safety of anakinra therapy in pediatric and adult patients with the autoinflammatory Muckle-Wells syndrome. Arthritis Rheum 63:840–849

    Article  PubMed  Google Scholar 

  8. Sarrabay G, Grandemange S, Touitou I (2015) Diagnosis of cryopyrin-associated periodic syndrome: challenges, recommendations and emerging concepts. Expert Rev Clin Immunol 11:827–835

    Article  CAS  PubMed  Google Scholar 

  9. Cuisset L, Jeru I, Dumont B, Fabre A, Cochet E, Le Bozec J et al (2011) Mutations in the autoinflammatory cryopyrin-associated periodic syndrome gene: epidemiological study and lessons from eight years of genetic analysis in France. Ann Rheum Dis 70:495–499

    Article  CAS  PubMed  Google Scholar 

  10. Hernández-Rodríguez J, Ruíz-Ortiz E, Tomé A, Espinosa G, González-Roca E, Mensa-Vilaró A et al (2016) Clinical and genetic characterization of the autoinflammatory diseases diagnosed in an adult reference center. Autoimmun Rev 15:9–15

    Article  PubMed  Google Scholar 

  11. Ter HNM, Oswald M, Jeyaratnam J, Anton J, Barron KS, Brogan PA et al (2015) Recommendations for the management of autoinflammatory diseases. Ann Rheum Dis 74:1636–1644

    Article  Google Scholar 

  12. Lv QW, Zhang W, Shi Q, Zheng WJ, Li X, Chen H et al (2015) Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial. Ann Rheum Dis 74:1078–1086

    Article  CAS  PubMed  Google Scholar 

  13. Vitale A, Lucherini OM, Galeazzi M, Frediani B, Cantarini L (2012) Long-term clinical course of patients carrying the Q703K mutation in the NLRP3 gene: a case series. Clin Exp Rheumatol 30:943–946

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Min Shen.

Ethics declarations

Disclosures

None.

Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81501405) and the Youth Research Funds of Peking Union Medical College (Grant No. 3332015092).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, D., Shen, M. Muckle-Wells syndrome in Chinese patients: a single center case series. Clin Rheumatol 36, 965–969 (2017). https://doi.org/10.1007/s10067-016-3523-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-016-3523-3

Keywords

Navigation