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Vol. 136. Issue S1.
Síndrome autoinflamatorio
Pages 10-15 (January 2011)
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Vol. 136. Issue S1.
Síndrome autoinflamatorio
Pages 10-15 (January 2011)
Síndrome CINCA/NOMID
Syndrome CINCA/NOMID
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4407
Consuelo Modesto
Médico Adjunto, Unidad de Reumatología Pediátrica, Hospital Vall d’Hebron, Barcelona, España
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Resumen

CINCA/NOMID es un síndrome conocido clínicamente desde 1981, mejor identificado en 1987 y cuya causa principal, si bien parece no ser única, fue descubierta en el año 2001 al encontrar mutaciones en el gen CIAS1 que modificaban la estructura de la proteína criopirina. A los síntomas principales que dieron lugar al nombre del síndrome – afectación neurológica, cutánea y articular – se han añadido otros síntomas menores pero muy constantes en los pacientes identificados: alteraciones pre y perinatales, rasgos morfológicos singulares y brotes febriles que se acompañan de alteraciones analíticas que ponen de manifiesto la existencia de un estado inflamatorio persistente. Los estudios radiológicos han podido identificar el origen fisario de las malformaciones osteoarticulares. CINCA/NOMID debe ser diferenciado de otros cuadros clínicos de comienzo similar en la época neonatal y primera infancia: artritis idiopática juvenil sistémica, fiebre periódica asociada al déficit de mevalonato cinasa, deficiencia humana del antagonista del receptor de IL-1 (DIRA) y síndrome de Muckle-Wells.

Palabras clave:
Criopirina
Gen CIAS1
Síndrome CINCA
Manifestaciones clínicas
Diagnóstico diferencial
Abstract

CINCA/NOMID syndrome was first reported in 1981, identified as a new disease in 1987 and the main cause discovered in 2001, when mutations in the CIAS1 gene modifying the structure of the protein cryopirin were found in those patients (although other factors seem to play a role). Together with the major symptoms that characterized the syndrome, neurological, cutaneous and articular manifestations, others have been added which seem to be quite constant among CINCA/NOMID diagnosed patients: pre and perinatal symptoms, morfological changes, outbreaks of fever and biological abnormalities which reveal a persistent inflammatory background. The radiological studies have been able to identify the physis as the origin of the osteoarticular malformations seen in this syndrome. Diferential diagnosis includes diseases with similar onset at the neonatal period or infancy: systemic onset juvenile idiopathic athritis, periodic fever associated with mevalonate kinase deficiency, deficiency of IL-1 receptor antagonist (DIRA) and Muckle-Wells syndrome.

Keywords:
Cryopyrin protein
CIAS1 gene
CINCA syndrome
Clinical manifestations
Differential diagnosis

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