Vasculitis in the autoinflammatory diseases

Curr Opin Rheumatol. 2017 Jan;29(1):4-11. doi: 10.1097/BOR.0000000000000347.

Abstract

Purpose of review: This article addresses the prevalence and relationship between autoinflammatory diseases and vasculitis.

Recent findings: Autoimmune diseases (AIDs) are a group of syndromes characterized by episodes of unprovoked inflammation due to dysregulation of the innate immune system. Despite the common occurrence of rashes and other skin lesions in these diseases, vasculitis is reported in only a few. On the other hand, neutrophilic dermatoses are more prevalent. Large vessel vasculitis is reported in patients with Behcet's and Blau's syndromes. Small and medium size vasculitides are reported in familial Mediterranean fever mainly as Henoch-Schonlein purpura and polyarteritis nodosa, respectively. It is rarely described in hyper IgD with periodic fever syndrome, cryopyrin associated periodic syndromes, TNF receptor-associated periodic syndrome, deficiency of interleukin-1 receptor antagonist and pyoderma gangrenosum and acne syndrome. In most AID where bones and skin are mainly involved (CRMO, Majeed syndrome, Cherubism and DITRA) - vasculitis has not been described at all. In AID small vessel vasculitis affects mainly the skin with no involvement of internal organs.

Summary: In AID, neutrophilic dermatoses are more common and prominent than vasculitis. This may reflect a minor role for interleukin-1 in the pathogenesis of vasculitis. The rarity of vasculitis in AID suggests that in most reported cases its occurrence has been probably coincidental rather than being an integral feature of the disease.

Publication types

  • Review

MeSH terms

  • Arthritis / complications
  • Autoimmune Diseases / complications
  • Familial Mediterranean Fever / complications
  • Hereditary Autoinflammatory Diseases / complications*
  • Humans
  • IgA Vasculitis / complications
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-1 / immunology
  • Pyoderma Gangrenosum / complications
  • Sarcoidosis
  • Skin Diseases / etiology
  • Synovitis / complications
  • Uveitis / complications
  • Vasculitis / etiology*
  • Vasculitis / immunology

Substances

  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-1

Supplementary concepts

  • Blau syndrome
  • Deficiency of interleukin-1 receptor antagonist