title: Modified regimen of etanercept for tumor necrosis factor receptor associated periodic syndrome (TRAPS) like illness.
abstract: BACKGROUND
  TRAPS, an autosomal dominant autoinflammatory disorder occurs due to mutations of the TNFRSF1A gene. Mutation negative TRAPS (TRAPS like illness) is also known. Anti TNF molecules (etanercept) is the mainstay of therapy.
  
  
  METHODS
  A 11-year-old boy with a 5 year clinical profile indicative of a TRAPS like illness and with negative mutation studies is described. He has been followed up for nearly 2 years after starting etanercept.
  
  
  RESULTS
  He had sustained response to etanercept which has subsequently been titrated (0.4 mg/kg subcutaneously every 23-24 days) to keep him symptom free.
  
  
  CONCLUSIONS
  Mutation negative cases of TRAPS can be diagnosed with a high index of suspicion. Treatment with etanercept is expensive but possibly intervals between doses could be titrated to reduce cost.
authors.affiliation: Pediatric Rheumatology Clinic, Jaslok Hospital and Research Center, Mumbai, Maharashtra, India. Correspondence to: Dr RP Khubchandani, Consultant Pediatrician, Jaslok Hospital and Breach Candy Hospital, Mumbai, Maharashtra, India. rajukhubchandani@yahoo.co.in.
authors.forename: Anita
authors.initials: A
authors.lastname: Dhanrajani
authors.forename: R P
authors.initials: RP
authors.lastname: Khubchandani
mesh_terms: D002648:Child; D000068800:Etanercept; D010505:Familial Mediterranean Fever / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008297:Male; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000235:genetics
chemical_list: D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; C506235:TNFRSF1A protein, human; D000068800:Etanercept