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Autoinflammation with arthritis and vasculitis(AIARV)

MedGen UID:
1855512
Concept ID:
C5935634
Disease or Syndrome
Synonyms: AIARV; AUTOINFLAMMATION WITH ARTHRITIS AND VASCULITIS
 
Gene (location): TBK1 (12q14.2)
 
Monarch Initiative: MONDO:0971173
OMIM®: 620880

Definition

Autoinflammation with arthritis and vasculitis (AIARV) is an autosomal recessive complex immunologic disorder with onset of symptoms in infancy or early childhood. Affected individuals have recurrent fever, erythematous skin rashes, vasculitis, oral aphthous lesions, and polyarthritis. Laboratory studies are consistent with an inflammatory state. Although patients may have recurrent infections, the infections are not severe. Additional features may include poor overall growth, microcytic anemia, mildly impaired intellectual development, seizures, and variable brain imaging abnormalities. Treatment with TNF (191160) inhibitors may result in clinical improvement (Taft et al., 2021). [from OMIM]

Clinical features

From HPO
Abdominal pain
MedGen UID:
7803
Concept ID:
C0000737
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) and perceived to originate in the abdomen.
Nephrotic syndrome
MedGen UID:
10308
Concept ID:
C0027726
Disease or Syndrome
Nephrotic syndrome is a collection of findings resulting from glomerular dysfunction with an increase in glomerular capillary wall permeability associated with pronounced proteinuria. Nephrotic syndrome refers to the constellation of clinical findings that result from severe renal loss of protein, with Proteinuria and hypoalbuminemia, edema, and hyperlipidemia.
Recurrent urinary tract infections
MedGen UID:
120466
Concept ID:
C0262655
Disease or Syndrome
Repeated infections of the urinary tract.
Vasculitis
MedGen UID:
12054
Concept ID:
C0042384
Disease or Syndrome
Inflammation of blood vessel.
Vasculitis in the skin
MedGen UID:
488809
Concept ID:
C0262988
Disease or Syndrome
A type of vasculitis (inflammation of blood vessel walls) that affects skeletal muscle tissue.
Leukocytoclastic vasculitis
MedGen UID:
445500
Concept ID:
C2973529
Disease or Syndrome
A type of vasculitis characterized by the presence of debris of neutrophils within the blood vessel walls.
Short stature
MedGen UID:
87607
Concept ID:
C0349588
Finding
A height below that which is expected according to age and gender norms. Although there is no universally accepted definition of short stature, many refer to "short stature" as height more than 2 standard deviations below the mean for age and gender (or below the 3rd percentile for age and gender dependent norms).
Disproportionate short-limb short stature
MedGen UID:
342370
Concept ID:
C1849937
Finding
A type of disproportionate short stature characterized by a short limbs but an average-sized trunk.
Visceromegaly
MedGen UID:
22659
Concept ID:
C0042782
Pathologic Function
Abnormal increased size of the viscera of the abdomen.
Feeding difficulties
MedGen UID:
65429
Concept ID:
C0232466
Finding
Impaired ability to eat related to problems gathering food and getting ready to suck, chew, or swallow it.
Villous atrophy
MedGen UID:
154306
Concept ID:
C0554101
Finding
The enteric villi are atrophic or absent.
Cerebral infarction
MedGen UID:
3321
Concept ID:
C0007785
Disease or Syndrome
A necrotic lesion in the cerebrum resulting from a sudden insufficiency of arterial or venous blood supply due to emboli, thrombi or mechanical factors.
Intellectual disability, mild
MedGen UID:
10044
Concept ID:
C0026106
Mental or Behavioral Dysfunction
Mild intellectual disability is defined as an intelligence quotient (IQ) in the range of 50-69.
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterized by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
Status epilepticus
MedGen UID:
11586
Concept ID:
C0038220
Disease or Syndrome
Status epilepticus is a type of prolonged seizure resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms which lead to abnormally prolonged seizures (after time point t1). It is a condition that can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures.
Delayed speech and language development
MedGen UID:
105318
Concept ID:
C0454644
Finding
A degree of language development that is significantly below the norm for a child of a specified age.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Motor delay
MedGen UID:
381392
Concept ID:
C1854301
Finding
A type of Developmental delay characterized by a delay in acquiring motor skills.
Ventriculomegaly
MedGen UID:
480553
Concept ID:
C3278923
Finding
An increase in size of the ventricular system of the brain.
Brain atrophy
MedGen UID:
1643639
Concept ID:
C4551584
Disease or Syndrome
Partial or complete wasting (loss) of brain tissue that was once present.
Thrombocytosis
MedGen UID:
163397
Concept ID:
C0836924
Disease or Syndrome
Increased numbers of platelets in the peripheral blood.
Microcytic anemia
MedGen UID:
1673948
Concept ID:
C5194182
Disease or Syndrome
A kind of anemia in which the volume of the red blood cells is reduced.
Arthritis
MedGen UID:
2043
Concept ID:
C0003864
Disease or Syndrome
Inflammation of a joint.
Recurrent sinusitis
MedGen UID:
107919
Concept ID:
C0581354
Disease or Syndrome
A recurrent form of sinusitis.
Autoimmunity
MedGen UID:
2136
Concept ID:
C0004368
Pathologic Function
The occurrence of an immune reaction against the organism's own cells or tissues.
Celiac disease
MedGen UID:
3291
Concept ID:
C0007570
Disease or Syndrome
Celiac disease is a systemic autoimmune disease that can be associated with gastrointestinal findings (diarrhea, malabsorption, abdominal pain and distension, bloating, vomiting, and weight loss) and/or highly variable non-gastrointestinal findings (dermatitis herpetiformis, chronic fatigue, joint pain/inflammation, iron deficiency anemia, migraines, depression, attention-deficit disorder, epilepsy, osteoporosis/osteopenia, infertility and/or recurrent fetal loss, vitamin deficiencies, short stature, failure to thrive, delayed puberty, dental enamel defects, and autoimmune disorders). Classic celiac disease, characterized by mild to severe gastrointestinal symptoms, is less common than non-classic celiac disease, characterized by absence of gastrointestinal symptoms.
Conjunctivitis
MedGen UID:
1093
Concept ID:
C0009763
Disease or Syndrome
Inflammation of the conjunctiva.
Exanthem
MedGen UID:
8732
Concept ID:
C0015230
Finding
A widespread rash.
Immunodeficiency
MedGen UID:
7034
Concept ID:
C0021051
Disease or Syndrome
Failure of the immune system to protect the body adequately from infection, due to the absence or insufficiency of some component process or substance.
Osteomyelitis
MedGen UID:
10497
Concept ID:
C0029443
Disease or Syndrome
Osteomyelitis is an inflammatory process accompanied by bone destruction and caused by an infecting microorganism.
Herpes simplex encephalitis
MedGen UID:
75794
Concept ID:
C0276226
Disease or Syndrome
Infection of the brain parenchyma with herpes simplex virus, resulting in inflammation of the brain parenchyma with neurologic dysfunction.
Lymphadenopathy
MedGen UID:
96929
Concept ID:
C0497156
Disease or Syndrome
Enlargement (swelling) of a lymph node.
Recurrent tonsillitis
MedGen UID:
1781351
Concept ID:
C0740402
Disease or Syndrome
Inflammation of the tonsils that has occurred repeatedly. The definition of recurrent may vary somewhat, but the criteria used recently as a measure of severity were five or more episodes of true tonsillitis per year, symptoms recurring for at least a year, and episodes that are disabling and that prevent normal functioning. In some cases recurrent tonsillitis may be related to immunosusceptibility. Evidence exists for a genetic predisposition for recurrent tonsillitis.
Inflammatory abnormality of the skin
MedGen UID:
849741
Concept ID:
C3875321
Disease or Syndrome
The presence of inflammation of the skin. That is, an abnormality of the skin resulting from the local accumulation of fluid, plasma proteins, and leukocytes.
Recurrent fever
MedGen UID:
811468
Concept ID:
C3714772
Sign or Symptom
Periodic (episodic or recurrent) bouts of fever.

Professional guidelines

PubMed

Burleigh A, Omoyinmi E, Papadopoulou C, Al-Abadi E, Hong Y, Price-Kuehne F, Moraitis E, Titheradge H, Montesi F, Xu D, Eleftheriou D, Brogan P
Rheumatology (Oxford) 2024 Dec 1;63(12):3457-3470. doi: 10.1093/rheumatology/kead628. PMID: 38006337Free PMC Article
Lötscher F, Kerstens F, Krusche M, Ruffer N, Kötter I, Turkstra F
Rheumatology (Oxford) 2023 Nov 2;62(11):3654-3661. doi: 10.1093/rheumatology/kead101. PMID: 36864623

Recent clinical studies

Etiology

Gutierrez-Rodrigues F, Kusne Y, Fernandez J, Lasho T, Shalhoub R, Ma X, Alessi H, Finke C, Koster MJ, Mangaonkar A, Warrington KJ, Begna K, Xie Z, Ombrello AK, Viswanatha D, Ferrada M, Wilson L, Go R, Kourelis T, Reichard K, Olteanu H, Darden I, Hironaka D, Alemu L, Kajigaya S, Rosenzweig S, Calado RT, Groarke EM, Kastner DL, Calvo KR, Wu CO, Grayson PC, Young NS, Beck DB, Patel BA, Patnaik MM
Blood 2023 Jul 20;142(3):244-259. doi: 10.1182/blood.2022018774. PMID: 37084382Free PMC Article
Lötscher F, Kerstens F, Krusche M, Ruffer N, Kötter I, Turkstra F
Rheumatology (Oxford) 2023 Nov 2;62(11):3654-3661. doi: 10.1093/rheumatology/kead101. PMID: 36864623
Omoyinmi E, Rowczenio D, Sebire N, Brogan PA, Eleftheriou D
Pediatr Rheumatol Online J 2021 Nov 22;19(1):161. doi: 10.1186/s12969-021-00645-8. PMID: 34809655Free PMC Article
Omoyinmi E, Standing A, Keylock A, Price-Kuehne F, Melo Gomes S, Rowczenio D, Nanthapisal S, Cullup T, Nyanhete R, Ashton E, Murphy C, Clarke M, Ahlfors H, Jenkins L, Gilmour K, Eleftheriou D, Lachmann HJ, Hawkins PN, Klein N, Brogan PA
PLoS One 2017;12(7):e0181874. Epub 2017 Jul 27 doi: 10.1371/journal.pone.0181874. PMID: 28750028Free PMC Article
Cantarini L, Imazio M, Brizi MG, Lucherini OM, Brucato A, Cimaz R, Galeazzi M
Clin Rev Allergy Immunol 2013 Feb;44(1):6-13. doi: 10.1007/s12016-010-8219-x. PMID: 21170606

Diagnosis

Lötscher F, Kerstens F, Krusche M, Ruffer N, Kötter I, Turkstra F
Rheumatology (Oxford) 2023 Nov 2;62(11):3654-3661. doi: 10.1093/rheumatology/kead101. PMID: 36864623
Hernández-Rodríguez J, Mensa-Vilaró A, Aróstegui JI
Med Clin (Barc) 2022 Nov 25;159(10):489-496. Epub 2022 Aug 29 doi: 10.1016/j.medcli.2022.06.018. PMID: 36049972
Omoyinmi E, Rowczenio D, Sebire N, Brogan PA, Eleftheriou D
Pediatr Rheumatol Online J 2021 Nov 22;19(1):161. doi: 10.1186/s12969-021-00645-8. PMID: 34809655Free PMC Article
Omoyinmi E, Standing A, Keylock A, Price-Kuehne F, Melo Gomes S, Rowczenio D, Nanthapisal S, Cullup T, Nyanhete R, Ashton E, Murphy C, Clarke M, Ahlfors H, Jenkins L, Gilmour K, Eleftheriou D, Lachmann HJ, Hawkins PN, Klein N, Brogan PA
PLoS One 2017;12(7):e0181874. Epub 2017 Jul 27 doi: 10.1371/journal.pone.0181874. PMID: 28750028Free PMC Article
Krause K, Grattan CE, Bindslev-Jensen C, Gattorno M, Kallinich T, de Koning HD, Lachmann HJ, Lipsker D, Navarini AA, Simon A, Traidl-Hoffmann C, Maurer M
Allergy 2012 Dec;67(12):1465-74. Epub 2012 Sep 15 doi: 10.1111/all.12030. PMID: 22978406

Therapy

Watanabe R, Hashimoto M
Front Immunol 2022;13:881705. Epub 2022 Mar 30 doi: 10.3389/fimmu.2022.881705. PMID: 35432355Free PMC Article
Yalcin AD, Yalcin AN
Immunopharmacol Immunotoxicol 2020 Aug;42(4):379-382. Epub 2020 Jul 7 doi: 10.1080/08923973.2020.1789656. PMID: 32605504
Gasparyan AY
Curr Pharm Des 2014;20(4):483-5. doi: 10.2174/138161282004140213121733. PMID: 23565640

Prognosis

Burleigh A, Omoyinmi E, Papadopoulou C, Al-Abadi E, Hong Y, Price-Kuehne F, Moraitis E, Titheradge H, Montesi F, Xu D, Eleftheriou D, Brogan P
Rheumatology (Oxford) 2024 Dec 1;63(12):3457-3470. doi: 10.1093/rheumatology/kead628. PMID: 38006337Free PMC Article
Gutierrez-Rodrigues F, Kusne Y, Fernandez J, Lasho T, Shalhoub R, Ma X, Alessi H, Finke C, Koster MJ, Mangaonkar A, Warrington KJ, Begna K, Xie Z, Ombrello AK, Viswanatha D, Ferrada M, Wilson L, Go R, Kourelis T, Reichard K, Olteanu H, Darden I, Hironaka D, Alemu L, Kajigaya S, Rosenzweig S, Calado RT, Groarke EM, Kastner DL, Calvo KR, Wu CO, Grayson PC, Young NS, Beck DB, Patel BA, Patnaik MM
Blood 2023 Jul 20;142(3):244-259. doi: 10.1182/blood.2022018774. PMID: 37084382Free PMC Article
Alhumam A
Int J Low Extrem Wounds 2023 Sep;22(3):620-624. Epub 2021 Aug 12 doi: 10.1177/15347346211036023. PMID: 34382449

Clinical prediction guides

Lötscher F, Kerstens F, Krusche M, Ruffer N, Kötter I, Turkstra F
Rheumatology (Oxford) 2023 Nov 2;62(11):3654-3661. doi: 10.1093/rheumatology/kead101. PMID: 36864623
Alhumam A
Int J Low Extrem Wounds 2023 Sep;22(3):620-624. Epub 2021 Aug 12 doi: 10.1177/15347346211036023. PMID: 34382449
Yalcin AD, Yalcin AN
Immunopharmacol Immunotoxicol 2020 Aug;42(4):379-382. Epub 2020 Jul 7 doi: 10.1080/08923973.2020.1789656. PMID: 32605504
Zhang Y, Shi W, Tang S, Li J, Yin S, Gao X, Wang L, Zou L, Zhao J, Huang Y, Shan L, Gounni AS, Wu Y, Yuan F, Zhang J
Arthritis Res Ther 2013 Oct 24;15(5):R161. doi: 10.1186/ar4344. PMID: 24286516Free PMC Article

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