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Síndrome de Muckle-Wells y síndrome autoinflamatorio familiar inducido por fríoSyndrome of Muckle-Wells and autoinflammatory familiar syndrome induced by cold

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Resumen

El síndrome autoinflamatorio familiar inducido por frío (FCAS) y el síndrome de Muckle-Wells forman parte del grupo de criopirinopatías o síndromes asociados a criopirina (CAPS) que presentan en común la presencia de mutaciones en el gen CIAS1. Los pacientes con diagnóstico de FCAS, aunque constituyen las formas clínicas más leves de este grupo, debutan en los primeros meses de vida y los síntomas se presentan tras la inducción por frío. El diagnóstico diferencial se plantea con los síndromes de urticarias adquiridas (ACU) y los síndromes familiares por frío atípicos (FACUS). Respecto al síndrome de Muckle-Wells (MWS) presenta, además de la fiebre y el exantema urticarial como síntomas recurrentes, la sordera neurosensorial progresiva que afectará al 60% de los pacientes, que junto con la amiloidosis secundaria ensombrecerá el pronóstico de este síndrome.

Abstract

Familial cold autoinflammatory syndrome (FCAS) and Muckle-Wells syndrome (MWS) belong to the cryopyrin-associated periodic syndromes (CAPS) with CIAS1 gene mutations as a common molecular basis. Patients with FCAS have the least severe clinical phenotype but are characterized by the development of symptoms induced by a generalized exposure to cold appearing during the first months of childhood. It is important to make differential diagnosis between FCAS and acquired cold urticaria (ACU) and familial atypical cold urticaria (FACU). Muckle-Wells syndrome is characterized by recurrent fever and urticarial rash, progressive sensorineural deafness and the development of secondary amyloidosis, but it is not considered the most severe disease of this group. Sensorineural deafness and amyloidosis are the two major complications of MWS and determine poor prognosis of the disease.

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