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The hereditary cryopyrinopathies are a group of autoinflammatory conditions triggered by cold ambient temperatures; they include familial cold autoinflammatory syndrome, Muckle-Wells syndrome, and neonatal-onset multisystem autoinflammatory disease.
Hereditary cryopyrinopathies represent a spectrum of progressively severe disease. They are due to mutations in the gene encoding the protein, cryopyrin, which mediates inflammation and IL-1β processing. Cryopyrin activity is augmented, triggering increased release of IL-1β from inflammasomes; the result is inflammation and fever.
Typically, familial cold autoinflammatory syndrome causes a cold-induced urticarial rash accompanied by fever.
Muckle-Wells syndrome causes intermittent fevers, urticarial rash, joint pain, and progressive deafness; 25% of patients develop amyloidosis.
Neonatal-onset multisystem autoinflammatory disease tends to cause joint deformities, meningitis, delayed development, and amyloidosis, in addition to fever and rash. As many as 20% of patients die by age 20.
The cryopyrinopathies are inherited as autosomal dominant disorders. They are treated with anakinra or etanercept.
Last full review/revision January 2009 by Stephen E. Goldfinger, MD
Content last modified January 2009
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