What is TRAPS?

Tumor necrosis factor Receptor Associated Periodic Syndrome, or TRAPS, is a very rare autoinflammatory disease that usually starts in children before the age of 4 years.1–5

References
1. Lainka E, Neudorf U, Lohse P et al. Rheumatology. 2009;48:987–91.
2. Samuels J, Ozen S. Curr Opin Rheumatol. 2006;18:108–17.
3. Lachmann HJ, Hawkins PN. Arthritis Res Ther. 2009;11:212.
4. Savic S, Dickie LJ, Battellino M et al. Curr Opin Rheumatol. 2012;24:103–12.
5. Gattorno M, Federici S, Pelagatti MA et al. J Clin Immunol. 2008;28(suppl 1):S73–83.

What are the symptoms of TRAPS?

TRAPS flares include the following symptoms:4,5,7

  • Persistent fever
  • Abdominal and/or chest pain
  • Nausea, vomiting, diarrhoea or constipation
  • Painful, often migrating red rash on the upper body and/or arms/legs
  • Swollen eyes (periorbital oedema) and/or conjunctivitis
  • Joint and muscle pain, often in areas where the rash occurs

TRAPS flares can last a few days to a few months, but typically last about 3 weeks.7
They usually occur spontaneously, but can also be triggered by:7

  • Minor injury 
  • Infection
  • Stress
  • Exercise
  • Hormonal changes
Possible Symptoms of Tumor necrosis factor Receptor Associated Periodic Syndrome (TRAPS)

Possible symptoms of TRAPS (modified according to 2,4,5,7,8)
 

What causes TRAPS in children?

With TRAPS, the innate immune system is activated due to changes in a gene coding for a protein called the tumor necrosis factor receptor, which is involved in the inflammatory response.2,7,11

The genetic change which leads to TRAPS developing in a child can be inherited from either parent. 2,7 There are cases of patients with non-inherited mutations for TRAPS, who can in turn pass the mutation on to their children.7
 

Is TRAPS a rare or common disease?

TRAPS is a very rare autoinflammatory disease that typically manifests in children before they reach the age of 4.1–5
 

What happens over the course of TRAPS?

Over the course of TRAPS, the fever bouts usually become less intense. Some patients can experience long periods of time between flares or have less frequent or severe flares in adulthood, but TRAPS is a lifelong condition.

In approximately 3 out of every 20 people, TRAPS can lead to amyloidosis.4 This is a condition in which a protein called amyloid builds up in the kidneys, eventually leading to kidney failure.9 But the good news is that recent advances in diagnostic techniques – which have helped to pinpoint a person’s precise type of amyloidosis, together with new medications, have meant that amyloidosis is now much more treatable than it used to be.10

References
1. Lainka E, Neudorf U, Lohse P et al. Rheumatology. 2009;48:987–91.
2. Samuels J, Ozen S. Curr Opin Rheumatol. 2006;18:108–17.
3. Lachmann HJ, Hawkins PN. Arthritis Res Ther. 2009;11:212.
4. Savic S, Dickie LJ, Battellino M et al. Curr Opin Rheumatol. 2012;24:103–12.
5. Gattorno M, Federici S, Pelagatti MA et al. J Clin Immunol. 2008;28(suppl 1):S73–83.
6. Lachmann HJ, Papa R, Gerhold K, et al. Ann Rheum Dis. Published Online First: 21 August 2013 doi:10.1136/annrheumdis-2013-204184.
7. US National Library of Medicine. Tumor necrosis factor receptor-associated periodic syndrome. Available from: http://ghr.nlm.nih.gov/condition/tumor-necrosis-factor-receptor-associated-periodic-syndrome (accessed 2015).
8. Drenth JPH, van der Meer JWM. NEJM. 2001;345:1748–1757.
9. Dember LM. J Am Soc Nephrol. 2006;17:3458–3471.
10. Wechelekar AD. Medicine. 2008;18:391-403.
11. Ciccarelli F, De Martinis M, Ginaldi L. Curr Med Chem. 2014;21:261–269.

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