Tumour Necrosis Factor Receptor Associated Periodic Fever Syndrome (TRAPS): A Diagnostic Challenge

Soorya Hegde, Janak Nayak, Khadija Rehman and Hassan Akhtar

Department of General Internal Medicine, County Hospital, United Kingdom Department of Acute Internal Medicine, County Hospital, United Kingdom Department of Respiratory Medicine, County Hospital, United Kingdom Department of Acute Medicine, County Hospital, United Kingdom

^*Correspondance to: Soorya Hegde 

 PDF  Full Text Case Report | Open Access

Abstract:

This report describes a case of late-onset TNF-Receptor Associated Periodic Fever Syndrome (TRAPS). We aim to describe the rare case of an 80-year-old Man, who had multiple Hospital admissions for prolonged episodes of fever with no clear cause found despite extensive investigation. Subsequent genetic testing revealed mutation in TNFRSF1A (TNF receptor superfamily member 1A) gene. This patient noticeably did not have a family history of prolonged / repeat episodes of fever or any of the other symptoms expected in TRAPS. He had raised inflammatory markers and showed a satisfactory response to intravenous antibiotic therapy on every occasion, which gave a false sense of security to the treating team, falling into the “trap of TRAPS,” which might be an appropriate metaphor for that argument. This is explained by the fact that infections are known to cause flare-ups in patients with TRAPS, although a definitive source of infection was not found on several occasions in our patient despite testing. This led to a diagnostic dilemma and ultimately a significant delay in diagnosis of the underlying condition. Treatment was started with Steroids [short-term] and Anakinra (Interleukin-1 inhibitor) [long-term], to which the patient showed an excellent response. This is one of the very few occasions where TRAPS is diagnosed at such a late age.

Keywords:

Cite the Article:

Hegde S, Nayak J, Rehman K, Akhtar H. Tumour Necrosis Factor Receptor Associated Periodic Fever Syndrome (TRAPS): A Diagnostic Challenge. Ann Clin Case Rep. 2024;9:2690..