Dalhousie University Discovers a Treatment for Rare Disorder

karrie

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Doctors discover treatment for disorder that feels like freezing on inside

Provided by: The Canadian Press
Written by: Alison Auld, THE CANADIAN PRESS
Mar. 9, 2008

HALIFAX - For more than three decades, Rachel Doherty and her siblings have endured the ravages of a rare illness that chills their insides while covering their skin in a painful rash.
Through her youth, the 62-year-old retiree from Prince Edward Island didn't even have a name for the condition that passed from one generation to the next, leaving most of her relatives feeling like they were "freezing from the inside out."
Now, years after her sister began a crusade to get help, doctors have discovered a treatment that frees them of the burning welts, swollen limbs, weakened immune systems, stomach aches and fever brought on by even the slightest drop in temperature.
"If you're always chilly, day in and day out for years and years, and all of a sudden you just get up and take a needle and you walk out and all the chills are gone ... it's amazing," Doherty said from her home in O'Leary, P.E.I., after receiving injections to quell the symptoms of Familial Cold Autoinflammatory Syndrome, or FCAS.
"It was like stepping into another body."
Doherty and eight of the 80 or so relatives across Canada who suffer from the little-known condition found relief after participating in clinical trials at Dalhousie University in Halifax in 2005.
For two months, doctors gave them daily injections of anakinra, a receptor-blocking therapy used for rheumatoid arthritis, and found their symptoms disappeared entirely within hours of receiving the shot.
Dr. Barrie Ross, a dermatologist at Dalhousie's medical school whose findings are being published this week, said the breakthrough comes after years of trying to understand the syndrome that afflicts only 600 people in about 15 families scattered across Europe, the United States and Canada.
Sufferers can experience a range of symptoms after only mild exposure to cold. Simply stepping on to a cool floor in the morning can cause joint pains, headaches and fever.
Ross pinpointed the syndrome's chromosomal site with researchers in Germany in the early 1990s and, with colleagues in the U.K., identified the specific receptor responsible for FCAS after six years of research.
That led them to look at drugs like anakinra, which had been proven to work in other inflammatory ailments.
"Early on they just knew the name, so you could diagnose it but there was nothing that could effectively treat it at all," he said about the research in the Journal of Cutaneous Medicine and Surgery.
"Now we have something that's proven to be continuously effective and there have been no proven side effects."
The syndrome coursed through Doherty's family, afflicting her mother, seven of her 14 siblings, several uncles and aunts, and her only child, Sabrina. Most were born with it, but had no way of treating what they simply referred to in French as the mauvais sang, or bad blood.
Doherty dealt with it by drinking up to 15 cups of coffee a day, popping Tylenol and bundling up in several layers of clothing.
For Sabrina Doherty, the revelation that drug injections might alleviate daily sicknesses that limited how much time she could spend outside, where she could live and how she dressed, gave her hope she might feel like other kids.
"It was probably one of the best experiences of my life - to feel normal, to be able to be like everyone else and wear one pair of pants and regular shoes and a long-sleeve shirt and not a jacket and not get sick," she said of the injections she was given during the trial.
"It was the first time I was able to be in a cold environment and not get sick."
The 32-year-old dispatcher, whose 12-year-old daughter also has FCAS, said the treatments carried no side effects and meant she could go out without putting on her usual attire - three pairs of socks, two sets of long johns, thick pants, three shirts and a sweater.
But the Dohertys and other relatives who participated in the trials aren't able to get the drug because of the $15,000 price tag for a yearly supply.
Each daily shot is about $50 and some insurers won't cover it because they argue there's no proof it's effective for the syndrome.
Ross and many in the family are hoping the release of his research will help them secure funding for the drug.
"The publication of our paper gives them ammunition to go to their provincial funding agent or insurer to say here's the proven trial that it is effective," Ross said.
 

Praxius

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Dec 18, 2007
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Interesting, sounds similar to something I have, but doesn't sound that bad. I am usually the first to freeze outside, usually cold even inside and have a room temp higher then most. Just about an hour ago I was over at my friend's place where they had the window open due to smoking. They left it open for a while and my right foot froze up and as I type this it has continually been shooting sharp pains up my leg. (It's been over an hour now)

But perhaps it's just because I grew up to put up with it, and perhaps it's because my family just never thought too much about it. From my understanding they have similar issues as well, but we don't bother to talk about it, because well, I guess we just don't think it's that bad.

I'll wear a couple of layers of clothing out in the winter, who doesn't? It's Canada. Yeah the cold in the hands and feet/legs can be pretty un-nerving at times.... much like this bugger right now in my foot!

But I always summed it up to just poor circulation and my overall body mass (Tall)

....or perhaps pinched nerves.

But if it's worse for other people beyond what I understand, then all the power to them to help them out if it works for them. Based on most of the symptoms listed above, it sounds like I qualify...

I suppose I could be a lab rat at Dal.... it's only a bus ride away, but I don't feel it's anything to the point where I'm going to spend $15,000 for the damn stuff. Even if it's covered by the health care, it's one thing I don't need to waste my time with. A pair of thick socks which I'm about to get are already paid for and cheaper.
 

karrie

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while I get what you're saying Prax, you don't really sound like you get "burning welts, swollen limbs, weakened immune systems, stomach aches and fever brought on by even the slightest drop in temperature."

You sound more like your family has Raynaud's or a similar syndrome
 

Praxius

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Nope, but if anything it's a much more milder relation to this more extreme case (In my developing theory here since they don't seem to know what is causing it) But a shot a day to remove the symptoms is not actually curing the problem now is it? Sounds more like a masking agent then anything. Reduces inflimation yes, but what is causing the inflimation?

Where they are getting very cold inside to the point where it causes burning rashes on the skin and it is similar to an inflimation, it sounds more like a circular issue once again, which the body is instinctively attempting to counter from an extreme exposure..... similar to an alergic reaction (Based on what I'm reading)

Since the body is producing a luctrative temperature shift and causing this problem, it also sounds like the colds and headaches are of course reactive to this change, making the body and mind react to it as if it is being attacked, as well as a possible infection/cold, therefore cold symptoms and being sick.

There are other people who have serious reactions to the sun and heat. But before I dabble my mind into that, and since I do not see a link to further information then provided.... was there any talk of any type of scans on the blood flow through the body via any Flash MRI or Real time blood flow imaging by spiral scan phase velocity mapping?
 

karrie

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It doesn't sound like a circulatory issue Prax, it's an autoimmune illness. Just because the two can both cause feelings of cold doesn't make them remotely similar. There are no cures yet for autoimmune diseases, just treatments. They're working on them though... rheumatoid arthritis, ankylosyng spondalytus, fibromyalgia, the whole lot of them.
 

Praxius

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It doesn't sound like a circulatory issue Prax, it's an autoimmune illness. Just because the two can both cause feelings of cold doesn't make them remotely similar. There are no cures yet for autoimmune diseases, just treatments. They're working on them though... rheumatoid arthritis, ankylosyng spondalytus, fibromyalgia, the whole lot of them.

Uh-huh.... maybe because they can not find any cures is because they're looking at it the wrong way. (I've seen way too many do this in the past, where they focus on one thing for too long and then for some reason forget other possibilities.... we're only human)

Once again, did they attempt any tests with the above techniques I mentioned? I actually am interested to know and I will explain why once I figure out which approaches they made.

Never mind, I'll just wait until their report is released to read what they have to say. (Just because I have too many directions I can go with my thought process at the moment.) There is a reason and method to my madness.
 
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