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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Allergy</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Allergy</journal-title><trans-title-group xml:lang="ru"><trans-title>Российский Аллергологический Журнал</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1810-8830</issn><issn publication-format="electronic">2686-682X</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">17065</article-id><article-id pub-id-type="doi">10.36691/RJA17065</article-id><article-id pub-id-type="edn">JKRIVU</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Case reports</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Клинические случаи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Variability of clinical symptoms of cryopyrin-associated periodic syndrome within the family</article-title><trans-title-group xml:lang="ru"><trans-title>Вариативность клинических проявлений криопирин-ассоциированного периодического синдрома в пределах одной семьи</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6646-4233</contrib-id><contrib-id contrib-id-type="spin">6424-0012</contrib-id><name-alternatives><name xml:lang="en"><surname>Markina</surname><given-names>Ulyana A.</given-names></name><name xml:lang="ru"><surname>Маркина</surname><given-names>Ульяна Алексеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>itcher.md@bk.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5132-1267</contrib-id><contrib-id contrib-id-type="spin">7249-4423</contrib-id><name-alternatives><name xml:lang="en"><surname>Roppelt</surname><given-names>Anna A.</given-names></name><name xml:lang="ru"><surname>Роппельт</surname><given-names>Анна Артуровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>roppelt_anna@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5949-5317</contrib-id><contrib-id contrib-id-type="spin">1491-2770</contrib-id><name-alternatives><name xml:lang="en"><surname>Zakharova</surname><given-names>Viktoria V.</given-names></name><name xml:lang="ru"><surname>Захарова</surname><given-names>Виктория Витальевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>neskvikk@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7247-545X</contrib-id><contrib-id contrib-id-type="spin">1538-3632</contrib-id><name-alternatives><name xml:lang="en"><surname>Golovina</surname><given-names>Oksana A.</given-names></name><name xml:lang="ru"><surname>Головина</surname><given-names>Оксана Андреевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ksan7ch@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5809-6015</contrib-id><contrib-id contrib-id-type="spin">3943-7930</contrib-id><name-alternatives><name xml:lang="en"><surname>Mutovina</surname><given-names>Zinaida Yu.</given-names></name><name xml:lang="ru"><surname>Мутовина</surname><given-names>Зинаида Юрьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), Assistant Professor</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент</p></bio><email>zmutovina@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3235-1425</contrib-id><contrib-id contrib-id-type="spin">6351-4980</contrib-id><name-alternatives><name xml:lang="en"><surname>Zagrebneva</surname><given-names>Alеna Igorevna</given-names></name><name xml:lang="ru"><surname>Загребнева</surname><given-names>Алёна Игоревна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), Assistant Professor</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент</p></bio><email>alrheumo@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-8318-5241</contrib-id><contrib-id contrib-id-type="spin">6632-2260</contrib-id><name-alternatives><name xml:lang="en"><surname>Petrusenko</surname><given-names>Yunna S.</given-names></name><name xml:lang="ru"><surname>Петрусенко</surname><given-names>Юнна Сергеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ypetrusenko@biotc.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-5425-584X</contrib-id><name-alternatives><name xml:lang="en"><surname>Gazieva</surname><given-names>Elina V.</given-names></name><name xml:lang="ru"><surname>Газиева</surname><given-names>Элина Вельтнуровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>elinagazieva23@yandex.ru</email><xref ref-type="aff" rid="aff6"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1930-5424</contrib-id><contrib-id contrib-id-type="spin">4122-5565</contrib-id><name-alternatives><name xml:lang="en"><surname>Karaulov</surname><given-names>Alexander V.</given-names></name><name xml:lang="ru"><surname>Караулов</surname><given-names>Александр Викторович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor, Academician of the Russian Academy of Sciences</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор, академик РАН</p></bio><email>drkaraulov@mail.ru</email><xref ref-type="aff" rid="aff7"/><xref ref-type="aff" rid="aff8"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6010-7975</contrib-id><contrib-id contrib-id-type="spin">3887-6250</contrib-id><name-alternatives><name xml:lang="en"><surname>Lysenko</surname><given-names>Maryana A.</given-names></name><name xml:lang="ru"><surname>Лысенко</surname><given-names>Марьяна Анатольевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор</p></bio><email>gkb52@zdrav.mos.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff9"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5083-6637</contrib-id><contrib-id contrib-id-type="spin">3023-4538</contrib-id><name-alternatives><name xml:lang="en"><surname>Fomina</surname><given-names>Darya S.</given-names></name><name xml:lang="ru"><surname>Фомина</surname><given-names>Дарья Сергеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Assistant Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, доцент</p></bio><email>daria_fomina@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff7"/><xref ref-type="aff" rid="aff10"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Moscow Clinical Science and Research Center Hospital No. 52</institution></aff><aff><institution xml:lang="ru">Московский клинический научно-исследовательский центр Больница № 52</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Endocrinology Research Centre</institution></aff><aff><institution xml:lang="ru">Национальный медицинский исследовательский центр эндокринологии имени академика И.И. Дедова</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Central State Medical Academy</institution></aff><aff><institution xml:lang="ru">Центральная государственная медицинская академия</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">North-Western State Medical University named after I.I. Mechnikov</institution></aff><aff><institution xml:lang="ru">Северо-Западный государственный медицинский университет имени И.И. Мечникова</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">Biotek Campus</institution></aff><aff><institution xml:lang="ru">Биотек Кампус</institution></aff></aff-alternatives><aff-alternatives id="aff6"><aff><institution xml:lang="en">Russian University of Medicine</institution></aff><aff><institution xml:lang="ru">Российский университет медицины</institution></aff></aff-alternatives><aff-alternatives id="aff7"><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University (Sechenovskiy University)</institution></aff><aff><institution xml:lang="ru">Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)</institution></aff></aff-alternatives><aff-alternatives id="aff8"><aff><institution xml:lang="en">LIFT Center</institution></aff><aff><institution xml:lang="ru">ЛИФТ Центр</institution></aff></aff-alternatives><aff-alternatives id="aff9"><aff><institution xml:lang="en">The Russian National Research Medical University named after N.I. Pirogov</institution></aff><aff><institution xml:lang="ru">Российский национальный исследовательский медицинский университет имени Н.И. Пирогова</institution></aff></aff-alternatives><aff-alternatives id="aff10"><aff><institution xml:lang="en">Astana Medical University</institution></aff><aff><institution xml:lang="ru">Медицинский университет Астана</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2026-02-03" publication-format="electronic"><day>03</day><month>02</month><year>2026</year></pub-date><pub-date date-type="pub" iso-8601-date="2026-04-06" publication-format="electronic"><day>06</day><month>04</month><year>2026</year></pub-date><volume>23</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>103</fpage><lpage>114</lpage><history><date date-type="received" iso-8601-date="2025-10-24"><day>24</day><month>10</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2026-01-26"><day>26</day><month>01</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, ABV-press</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, АБВ-пресс</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">ABV-press</copyright-holder><copyright-holder xml:lang="ru">АБВ-пресс</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2028-04-06"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://rusalljournal.ru/raj/about/submissions#copyrightNotice</ali:license_ref></license></permissions><self-uri xlink:href="https://rusalljournal.ru/raj/article/view/17065">https://rusalljournal.ru/raj/article/view/17065</self-uri><abstract xml:lang="en"><p>Cryopyrin-associated periodic syndrome is a group of autoinflammatory diseases caused by mutations in the <italic>NLRP3</italic> gene, which lead to uncontrolled inflammasome activation and, consequently, excessive production of the proinflammatory cytokine interleukin 1β. Diagnosis is challenging, since many patients have a heterogeneous multisystem clinical picture. This publication presents a familial case of the disease with variability of manifestations from “blurred” and asymptomatic to a detailed clinical picture with multisystem involvement (persistent inflammatory activity, fever and urticaria associated with cold exposure, erythema nodosum, poly- and monoarthritis, uveitis, aphthous stomatitis, scrotal ulcers, and headache). Two patients had an atypical presentation of symptoms with predominant involvement of the joints, eyes, and oral mucosa, due to which one of them was initially given an alternative diagnosis of Behcet’s disease (syndrome). Genetic testing made it possible to identify a pathogenic mutation in the <italic>NLRP3</italic> gene, verify the diagnosis, and promptly prescribe pathogenetic therapy with an interleukin 1 inhibitor, which is necessary to prevent irreversible organ damage (amyloidosis, sensorineural hearing loss, vision loss, etc.) and reduce the burden of the disease.</p></abstract><trans-abstract xml:lang="ru"><p>Криопирин-ассоциированный периодический синдром — группа аутовоспалительных заболеваний, обусловленных мутациями гена<italic> NLRP3</italic>, которые приводят к неконтролируемой активации инфламмасом и, как следствие, избыточной продукции провоспалительного цитокина интерлейкина 1β. Постановка диагноза представляет собой сложную задачу, поскольку у многих пациентов наблюдается гетерогенная мультисистемная клиническая картина.</p> <p>В статье представлено описание семейного случая заболевания с вариативностью проявлений от «стертых» и малосимптомных до развернутой клинической картины с полисистемным поражением (персистирующая воспалительная активность, лихорадка и крапивница, ассоциированные с холодовым фактором, узловатая эритема, поли- и моноартриты, увеит, афтозный стоматит, язвы области мошонки, головная боль). У 2 пациентов имелась нетипичная презентация симптомов с преобладанием поражения суставов, глаз и слизистой оболочки полости рта, в связи с чем одному из них исходно установлен альтернативный диагноз болезни (синдрома) Бехчета. Проведение генетического тестирования позволило выявить патогенную мутацию в гене <italic>NLRP3,</italic> верифицировать диагноз, своевременно назначить патогенетическую терапию ингибитором интерлейкина 1, что необходимо для предотвращения необратимых повреждений органов (амилоидоз, нейросенсорная тугоухость, потеря зрения и др.) и снижения бремени болезни.</p></trans-abstract><kwd-group xml:lang="en"><kwd>cryopyrin-associated periodic syndrome</kwd><kwd>anticytokine therapy</kwd><kwd>Behcet’s disease (syndrome)</kwd><kwd>adults</kwd><kwd>familial case</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>криопирин-ассоциированный периодический синдром</kwd><kwd>антицитокиновая терапия</kwd><kwd>болезнь (синдром) Бехчета</kwd><kwd>взрослые</kwd><kwd>семейный случай</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Kuemmerle-Deschner JB, Ozen S, Tyrrell PN, et al. 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