Treatment of the Nephrotic Syndrome with Etanercept in Patients with the Tumor Necrosis Factor Receptor–Associated Periodic Syndrome

To the Editor: The tumor necrosis factor (TNF) receptor–associated periodic syndrome is a dominantly inherited, chronic inflammatory condition characterized by lifelong febrile attacks of abdominal and musculoskeletal pain associated with skin lesions. The attacks vary in severity and in frequency, usually last from 3 to 21 days, and respond to high-dose corticosteroids. Soluble TNF receptors can inhibit TNF activity by binding and preventing the interaction of TNF-α (TNFSF2) with its cell-surface receptor. Recombinant human TNF receptor (TNFRSF1B) (p75):Fc fusion protein (etanercept) inhibits the activity of TNF in vitro and reduces inflammation in animal models.1 We evaluated a woman with the . . .