@article {3577, title = {Serum amyloid protein A concentration in cryopyrin-associated periodic syndromes patients treated with interleukin-1 beta antagonist.}, journal = {Clin Exp Rheumatol}, volume = {32}, year = {2014}, month = {2014 Jul-Aug}, pages = {S63-6}, abstract = {

OBJECTIVES: Cryopyrin-associated periodic syndromes (CAPS) are a group of chronic, relapsing autoinflammatory disorders which may be complicated by systemic AA amyloidosis. The aim of our study was to evaluate serum amyloid protein A (SAA) level in CAPS patients treated with Interleukin-1beta (IL-1β) antagonist and to correlate its level with treatment response.

METHODS: All patients of CAPS Italian Register treated with IL-1β inhibitor were enrolled. SAA levels before starting therapy, and at last visit were evaluated. Patients were then divided in complete responders and partial responders.

RESULTS: Twenty-five patients were enrolled. SAA level before starting therapy was increased (median 118.5 mg/L, IQR 96.4-252.8; normal value <6.4 mg/L), while at last visit SAA was significantly reduced (median 4.3 mg/L, IQR 2.3-12.7) (p<0.001). However 12 patients still presented SAA levels beyond normal range, 10/25 patients (40\%) showed a complete response to treatment. Conversely, 15 patients presented only a partial response, of which 12 for increased SAA value and 3 for increased CRP value. Patients with partial response had SAA values significantly higher than patients with complete response (median 12.6 mg/L; IQR 8.3-20.0 vs. 2.7 mg/L; IQR 1.6-4.1, p<0.001).

CONCLUSIONS: Our results confirm the long term efficacy of anti IL-1β treatment in CAPS and the decrease of SAA levels; however 48\% of patients still presented SAA elevation despite treatment. The real risk of these patients in developing amyloidosis is not clear but the persistent increase of SAA needs a close follow-up.

}, keywords = {Adolescent, Adult, Amyloidosis, Child, Child, Preschool, Cryopyrin-Associated Periodic Syndromes, Drug Monitoring, Female, Humans, Immunosuppressive Agents, Interleukin-1beta, Male, Middle Aged, Serum Amyloid A Protein, Treatment Outcome, Young Adult}, issn = {0392-856X}, author = {Pastore, Serena and Paloni, Giulia and Caorsi, Roberta and Ronfani, Luca and Taddio, Andrea and Lepore, Loredana} } @article {1792, title = {A singular case of congenital self-healing histiocytosis with skin, liver and atypical eye involvement.}, journal = {Ocul Immunol Inflamm}, volume = {19}, year = {2011}, month = {2011 Oct}, pages = {337-9}, abstract = {

PURPOSE: To describe a rare case of congenital self-healing Langerhans cell histiocytosis (CSHLCH) presenting with atypical eye involvement.

DESIGN: Case report.

METHODS: A female newborn presented with purpuric lesions over the trunk, limbs, and face. Liver ultrasonography revealed hypoechogenic lesions with blurred borders. Biomicroscopy showed right posterior synechiae with fibrinoid deposits on the lens. At 7 months she presented with right acute glaucoma.

RESULTS: Biomicroscopy showed the presence of inflammatory pseudo-membrane covering the anterior surface of the lens, iris, and iridocorneal angle. Ab externo trabeculotomy was performed; access to the anterior chamber with capsulorrhexis forceps permitted a peeling of the pseudo-membrane with normalization of the intraocular pressure. Histologic examination of the membrane revealed an inflammatory tissue with CD1a and S-100 positive histiocytic cells.

CONCLUSIONS: This is the first case of CSHLCH describing acute glaucoma secondary to a pseudo-inflammatory membrane with typical histiocytic cells, occluding the iridocorneal angle.

}, keywords = {Antigens, CD1, Convalescence, Female, Glaucoma, Histiocytosis, Langerhans-Cell, Humans, Infant, Intraocular Pressure, Iridocorneal Endothelial Syndrome, Liver Diseases, S100 Proteins, Skin Diseases, Trabeculectomy}, issn = {1744-5078}, doi = {10.3109/09273948.2010.605538}, author = {Parentin, Fulvio and Ventura, Giovanna and Pastore, Serena and Kiren, Valentina and Bibalo, Chiara and Pensiero, Stefano and Lepore, Loredana} }