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Schnitzler syndrome, a rare autoinflammatory disease. Complete response to IL-1 blockade

Paola Faggioli, Antonio Tamburello, Lucia Roncoroni, Antonino Mazzone
  • Paola Faggioli
    Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
  • Antonio Tamburello
    Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
  • Lucia Roncoroni
    Pathology Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy

Abstract

The Schnitzler syndrome (SCS) is a rare, late-onset acquired autoinflammatory syndrome often underdiagnosed. The diagnosis is based on the Lipsker and recently on validated Strasbourg diagnostic criteria (chronic urticarial rash, monoclonal gammopathy, intermittent fever, arthritis, arthralgia, bone involvement, hepatomegaly, splenomegaly, lymphadenopathy, dermal infiltration of neutrophils and laboratory markers of inflammation). Conventional therapies including anti-histamines, anti-inflammatory drugs, corticosteroids and immunosuppressive drugs that are usually ineffective. Recently the gold standard therapy of SCS are considered IL-1 blocking agents as anakinra, canakinumab, rilonacept that led to a significant control of clinical symptoms, even if a relapse could appear at suspension of the treatment. We report a case of a 63-year-old man with a recent diagnosis of SCS - after 6 years of symptoms of disease - refractory to several conventional immunosuppressive therapies and treated with anakinra, with sustained remission of clinic manifestations during treatment at 24 months of follow up.

Keywords

Schnitzler syndrome; autoinflammatory disease; IL-1 blockade.

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Submitted: 2017-08-21 09:31:05
Published: 2017-12-12 11:40:54
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Copyright (c) 2017 Paola Faggioli, Antonio Tamburello, Lucia Roncoroni, Antonino Mazzone

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