una, la Challenges in the diagnosis and management of NLRP3-associated autoinflammatory disease in Latin America: report of the first two families in Paraguay

Authors

Keywords:

NLR Family, Pyrin Domain-Containing 3 Protein, Latin America, Hereditary Autoinflammatory Diseases, Cryopyrin-Associated Periodic Syndromes

Abstract

We present the first two Paraguayan families carrying NLRP3 inflammasome gain-of-function variants. One family exhibited a phenotype consistent with Muckle–Wells syndrome, including atypical neurological manifestations (West Syndrome), while the other showed predominantly cold-induced urticaria. These cases highlight the phenotypic variability of NLRP3-associated autoinflammatory diseases and underscore the importance of increasing awareness, improving access to genetic testing, and expanding availability of targeted therapies in Paraguay.

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Author Biographies

Natalia Cabrera, Universidad Católica “Nuestra Señora de la Asunción”, Facultad de Ciencias de la Salud, Laboratorio de Enfermedades Autoinflamatorias

Pediatric Rheumatologist

Cynthia Vega, Universidad Católica “Nuestra Señora de la Asunción”, Facultad de Ciencias de la Salud, Laboratorio de Enfermedades Autoinflamatorias

Pediatric Rheumatologist

Jorge López-Benítez, Centro Médico La Costa, Reumatología Pediátrica

Pediatric Rheumatologist

References

1. Mariathasan S, Weiss DS, Newton K, McBride J, O’Rourke K, Roose-Girma M, et al. Cryopyrin activates the inflammasome in response to toxins and ATP. Nature. 2006 Mar 9;440(7081):228–32.

2. Carta S, Penco F, Lavieri R, Martini A, Dinarello CA, Gattorno M, et al. Cell stress increases ATP release in NLRP3 inflammasome-mediated autoinflammatory diseases, resulting in cytokine imbalance. Proc Natl Acad Sci U S A. 2015 Mar 3;112(9):2835–40.

3. Ben-Chetrit E, Gattorno M, Gul A, Kastner DL, Lachmann HJ, Touitou I, et al. Consensus proposal for taxonomy and definition of the autoinflammatory diseases (AIDS): A Delphi study. Ann Rheum Dis. 2018;77(11):1558–65.

4. De Benedetti F, Gattorno M, Anton J, Ben-Chetrit E, Frenkel J, Hoffman HM, et al. Canakinumab for the Treatment of Autoinflammatory Recurrent Fever Syndromes. New England Journal of Medicine. 2018 May 17; 378(20):1908–19.

5. Mytinger JR. Definitions and Diagnostic Criteria for Infantile Spasms and West Syndrome – Historical Perspectives and Practical Considerations. Vol. 38, Seminars in Pediatric Neurology. W.B. Saunders; 2021.

6. Milhavet F, Stojanovic K, Wouters CH, et al. The Infevers autoinflammatory mutation online registry: update with new genes and functions. Hum Mutat. 2008;29(6): 803–808. Available from: https://infevers.umai-montpellier.fr/web/

7. Moltrasio C, Romagnuolo M, Marzano AV. NLRP3 inflammasome and NLRP3-related autoinflammatory diseases: From cryopyrin function to targeted therapies. Vol. 13, Frontiers in Immunology. Frontiers Media S.A.; 2022.

8. Haginoya K, Noguchi R, Zhao Y, Munakata M, Yokoyama H, Tanaka S, et al. Reduced levels of interleukin-1 receptor antagonist in the cerebrospinal fluid in patients with West syndrome. Epilepsy Res. 2009 Aug;85(2–3): 314–7.

9. Kuemmerle-Deschner JB, Ozen S, Tyrrell PN, Kone-Paut I, Goldbach-Mansky R, Lachmann H, et al. Diagnostic criteria for cryopyrin-associated periodic syndrome (CAPS). Ann Rheum Dis. 2017;76(6): 942–7.

10. Masters SL, Simon A, Aksentijevich I, Kastner DL. Horror autoinflammaticus: The molecular pathophysiology of autoinflammatory disease. Vol. 27, Annual Review of Immunology. 2009. p. 621–68.

Published

2025-12-01