An autoinflammatory disease due to homozygous deletion of the IL1RN locus.

Reddy, Sreelatha; Jia, Shuang; Geoffrey, Rhonda; Lorier, Rachel; Suchi, Mariko; Broeckel, Ulrich; Hessner, Martin J; Verbsky, James · N Engl J Med · 2009

case_report · Level V

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Abstract

We describe a patient with an autoinflammatory disease in which the main clinical features are pustular rash, marked osteopenia, lytic bone lesions, respiratory insufficiency, and thrombosis. Genetic studies revealed a 175-kb homozygous deletion at chromosome 2q13, which encompasses several interleukin-1 family members, including the gene encoding the interleukin-1-receptor antagonist (IL1RN). Mononuclear cells, obtained from the patient and cultured, produced large amounts of inflammatory cytokines, with increasing amounts secreted after stimulation with lipopolysaccharide. A similar increase was not observed in peripheral-blood mononuclear cells from a patient with neonatal-onset multisystem inflammatory disorder (NOMID). Treatment with anakinra completely resolved the symptoms and lesions.

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