Muckle–Wells syndrome
{{Expand German|Muckle-Wells syndrome|date=December 2023}}
{{Use dmy dates|date=July 2017}}
{{Infobox medical condition (new)
| name = Muckle–Wells syndrome
| synonyms = Urticaria-deafness-amyloidosis syndrome (UDA),[http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=575 ORPHANET – About rare diseases – About orphan drugs]
| image = Autosomal dominant - en.svg
| caption = This condition is inherited in an autosomal dominant manner
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| field = Clinical Immunology
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Muckle–Wells syndrome (MWS) is a rare autosomal dominant disease which causes sensorineural deafness and recurrent hives, and can lead to amyloidosis. Individuals with MWS often have episodic fever, chills, and joint pain. As a result, MWS is considered a type of periodic fever syndrome. MWS is caused by a defect in the CIAS1 gene which creates the protein cryopyrin. MWS is closely related to two other syndromes, familial cold urticaria and neonatal onset multisystem inflammatory disease—in fact, all three are related to mutations in the same gene and subsumed under the term cryopyrin-associated periodic syndromes (CAPS).
Sign and symptoms
- Sensorineural deafness
- Recurrent urticaria (hives)
- Fevers
- Chills
- Arthralgia (painful joints)
Causes
Muckle-Wells syndrome occurs when a mutation in the NLRP3 gene leads to increased activity of the protein NLRP3 (cryopyrin). This protein is partly responsible for the body's response to damage or infection. During these states, a cytokine called interleukin 1β is produced by an innate immune cell known as a macrophage. This cytokine interacts with a receptor on the surface of other immune cells to produce symptoms of inflammation such as fever, arthritis, and malaise. Increased activity of cryopyrin leads to an increase in interleukin 1β, which in turn leads to inflammation all throughout the body with the associated symptoms.{{cite journal | pmid = 16407890 |name-list-style=vanc| last1 = Mariathasan | first1 = S| doi=10.1038/nature04515 | last2 = Weiss | first2 = DS | last3 = Newton | first3 = K | last4 = McBride | first4 = J | last5 = O'Rourke | first5 = K | last6 = Roose-Girma | first6 = M | last7 = Lee | first7 = WP | last8 = Weinrauch | first8 = Y | last9 = Monack | first9 = DM | last10 =Dixit | first10 =Vishva M. | title = Cryopyrin activates the inflammasome in response to toxins and ATP | journal = Nature | volume=440 | issue=7081 | pages = 228–32 |date=March 2006| display-authors =8 |bibcode=2006Natur.440..228M| doi-access = free }}
Diagnosis
{{Empty section|date=January 2017}}
Treatment
- Treatment with anakinra, an interleukin 1 receptor antagonist, can lead to an improvement in the hearing loss.{{cite journal | pmid = 16531551 |name-list-style=vanc| last1 = Rynne | pmc = 1798106 | first1 = M| doi=10.1136/ard.2005.038091 | last2 = MacLean | first2 = C | last3 = Bybee | first3 = A | last4 = McDermott | first4 = MF | last5 = Emery | first5 = P | title = Hearing improvement in a patient with variant Muckle-Wells syndrome in response to interleukin 1 receptor antagonism | journal = Annals of the Rheumatic Diseases | volume=65 | issue=4 | pages = 533–4 |date=April 2006}}
- Rilonacept (Arcalyst) a dimeric fusion protein for the treatment of CAPS.
- Canakinumab, a monoclonal antibody against interleukin-1β
Prognosis
The chronic inflammation present in MWS over time can lead to sensorineural hearing loss. In addition, the prolonged inflammation can lead to deposition of proteins in the kidney, a condition known as amyloidosis.{{citation needed|date=November 2020}}
History
MWS was first described in 1962 by Thomas James Muckle (1938–2014){{cite news|last1=Churchill|first1=Dave|title=Former McMaster professor had taste for adventure and great wine|url=http://www.thespec.com/news-story/5206266-former-mcmaster-professor-had-taste-for-adventure-and-great-wine/|publisher=Hamilton Spectator}} and Michael Vernon Wells (born 1932).{{cite journal | pmid = 14476827 | last1 = Muckle |name-list-style=vanc| first1 = TJ | title = Urticaria, deafness, and amyloidosis: a new heredo-familial syndrome | journal = The Quarterly Journal of Medicine| volume=31 | pages = 235–48 |date=April 1962}}
Society and culture
The CBC Radio One program, White Coat, Black Art, hosted by Dr. Brian Goldman, presents a real-life study of the self-diagnosis by and successful treatment of a father and daughter with Muckle–Wells syndrome.{{cite web|title= White Coat Black Art: Man googles rash, discovers he has one-in-a-million rare disease|url = https://www.cbc.ca/radio/whitecoat/man-googles-rash-discovers-he-has-one-in-a-million-disease-1.3776375/man-googles-rash-discovers-he-has-one-in-a-million-rare-disease-1.3776381|date=2024-10-03| archive-url = http://web.archive.org/web/20240424045213/https://www.cbc.ca/radio/whitecoat/man-googles-rash-discovers-he-has-one-in-a-million-disease-1.3776375/man-googles-rash-discovers-he-has-one-in-a-million-rare-disease-1.3776381 | archive-date = 2024-04-24}}
In the episode of popular TV series House, the main patient of the Season 7 episode Recession Proof is ultimately diagnosed with this condition.{{Cite episode|series=House|season=7|number=14|minutes=35|transcript=Transcript at forever dreaming.org|transcript-url=https://transcripts.foreverdreaming.org/viewtopic.php?t=43621}}
In an episode of TV series Cake Boss, Buddy Valastro works with a girl with this condition through Make-A-Wish Foundation.{{cite web | title="Cake Boss" Hot Air Balloon Cake & Happy Little Bakers (TV Episode 2011) | website=IMDb | date=16 November 2024 | url=https://www.imdb.com/title/tt1860409/plotsummary/ | access-date=16 November 2024}}
See also
- Familial cold urticaria, a similar disease
- List of cutaneous conditions
- NOMID, a similar disease
- Urticarial syndromes
- CINCA Syndrome
References
{{reflist}}
External links
{{Medical resources
| DiseasesDB = 30159
| ICD10 = {{ICD10|E|85|0|e|75}}, {{ICD10|L|50|8|l|50}}
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| OMIM = 191900
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| MeshID = D056587
| Orphanet = 575
}}
{{DEFAULTSORT:Muckle-Wells syndrome}}
Category:Autoinflammatory syndromes
Category:Rare genetic syndromes