Symptoms of Tumor necrosis factor receptor associated periodic syndrome
- • Recurrent episodes of fever, erysipelas-like rash (often quite painful), myalgia, serositis (peritonitis in 90%) and conjunctivitis. Periorbital swelling is common and is a distinguishing characteristic.
- • Symptom onset generally in the first and second decade of life, but age of onset can vary up to middle-age.
- • Rash is more common at the distal extremities and face (centrifugal pattern) and may be migratory.
- • Arthralgias >> arthritis (arthritis is typically monoarticular, if present).
- • Myalgia commonly involves the thigh; often migrates to additional areas.
- • Inflammatory markers will be elevated during flares, which are often longer in duration than FMF attacks (>5-7 days, on average lasting 2–4 weeks).
- • Recurrence of attacks: average 2 to 6 attacks per year.
- • Amyloidosis occurs in about 10% of patients, which is less than what is seen in untreated FMF (monitor with urinalysis to identify proteinuria, as well as serum creatinine).
