Kalpana Kalpana (Editor)

Muckle–Wells syndrome

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Specialty
  
dermatology

OMIM
  
191900

MeSH
  
D056587

ICD-10
  
E85.0, L50.8

DiseasesDB
  
30159

Muckle–Wells syndrome (MWS), also known as urticaria-deafness-amyloidosis syndrome (UDA), is a rare autosomal dominant disease which causes sensorineural deafness, 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).

Contents

Sign and symptoms

  • Sensorineural deafness
  • Recurrent urticaria (hives)
  • Fevers
  • Chills
  • Arthralgia (painful joints)
  • Causes

    MWS occurs when a mutation in the CIAS1 gene, encoding for NLRP3, leads to increased activity of the protein 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. In MWS, the increased activity of cryopyrin leads to an increase in interleukin 1β. This leads to inflammation all throughout the body with the associated symptoms.

    Treatment

  • Treatment with anakinra, an interleukin 1 receptor antagonist, can lead to an improvement in the hearing loss.
  • 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 deafness. In addition, the prolonged inflammation can lead to deposition of proteins in the kidney, a condition known as amyloidosis.

    History

    MWS was first described in 1962 by Thomas James Muckle (1938-2014) and Michael Vernon Wells (born 1932).

    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: 24th September 2016 episode

    In the episode of popular TV series House, the main patient of the Season 7 episode Recession Proof is ultimately diagnosed with this condition.In an episode of TV series Cake Boss, Buddy Valastro works with a girl with this condition through Make-A-Wish Foundation.

    References

    Muckle–Wells syndrome Wikipedia