Diagnostic Tools/Genetic Testing

 Diagnostic Tools for Autoinflammatory Diseases

Genetic testing and other helpful resources for periodic fever syndromes.

Click here for a printable PDF of these resources.

autoinflamamtory databaseSystemic Autoinflammatory Diseases Database

Edited and Co-authored by Autoinflammatory Alliance President Karen Durrant, RN BSN and leading experts on autoinflammatory diseases, this free online database describes the notable symptoms of currently known autoinflammatory syndromes. This database has become a highly respected and important diagnostic tool for doctors around the world. Since these diseases can be very similar and have overlapping symptoms, the chart can help narrow down which SAIDs to consider for a patient and can help guide further testing.

Eurofever Classification Criteria

This diagnostic questionnaire by the EUROFEVER project is really helpful for doctors considering symptoms when trying to diagnose some of the hereditary periodic fever (autoinflammatory) syndromes, like CAPS, TRAPS, HIDS and FMF.

fever syndrome genetic testing

DNA photo by Mike_Kiev/Bigstockphoto.com

Genetic Testing

For many of the periodic fever syndromes/autoflammatory diseases, there is genetic testing available to help with diagnosis. Genetic testing for mutations on genes known to cause autoinflammatory diseases can also be used to help rule out possible syndromes when making a clinical diagnosis. Often insurance will cover the full cost of these tests, but check with your provider to determine if these tests are covered.

Since many of the autoinflammatory diseases share similar symptoms that may include recurrent high fevers, mouth ulcers, swollen lymph nodes, rashes, joint pain and/or swelling and other symptoms, running a fever panel that tests for multiple syndromes at once is both efficient and cost effective. It also reduces the chances of missing the cause of the symptoms or missing comorbid conditions when an individual patient has genetics for multiple autoinflammatory diseases.

The most common fever syndrome PFAPA does not have a genetic test, but ruling out fever syndromes that can have similar symptoms, such as HIDS, CAPS, FMF, Behcet-like familial autoinflammatory syndrome (HA20) and TRAPS is important when diagnosing PFAPA. Doctors Lawson and Hersh state, “The various periodic fever syndromes have overlapping symptoms; therefore, a definitive diagnosis of PFAPA cannot be made until other periodic fever syndromes have been excluded via genetic testing…

There are several labs in the U.S. that have panels available for periodic fever syndromes. Below are the commonly used panels. All use next generation DNA sequencing and are very accurate tests.

The larger panels by MNG Laboratories, Blueprint Genetics, Prevention Genetics, Avantra Genetics (a division of Courtagen), and Fulgent test for several fever syndromes and other conditions that may have similar symptoms, recurring fevers, recurring symptoms, and/or involve cytokine dysregulation. Some genes included in these panels are related to immune deficiencies.

Autoinflammatory Genetic Panel Comparisons; Genes Tested by Lab

Use the search box to search for a specific gene or disease and to see what labs include that condition in their panel. Below the chart, use the scroll bar or the "Next" button to see more labs and genes. On a phone you can swipe to move the chart and see all the labs.
 MNG LaboratoriesAvantra GeneticsFulgentInvitaeBlueprint GeneticsPrevention GeneticsARUP Laboratories and GeneDx
Number of Genes3633272625137
Cost$1995 Bills contracted institutions. Self-pay available.$389 Self-pay only.Pricing not listed on website. Will bill insurance. Patient assistance/ payment plans available.Patient-pay price of $475 per clinical area. Will bill insurance. Copay assistance available.$1400 Will bill insurance. Financial assistance available.$1440 Will bill insurance.Pricing not listed on website. Will bill insurance.
Test NameFever SyndromesAutoinflammatory PanelPeriodic Fever/Autoinflammatory Disorders NGS PanelAutoinflammatory Syndromes PanelAutoinflammatory Syndrome PanelPeriodic Fever Syndromes Sequencing PanelPeriodic Fever Syndromes Panel
MEFV – Familial Mediterranean Fever (FMF)XXXXXXX
LPIN2 – Majeed SyndromeXXXXXXX
MVK – Mevalonate Kinase Deficiencies (MKD): HIDS and MAXXXXXXX
NLRP3 – Cryopyrin Associated Periodic Syndromes (CAPS): MWS, FCAS, and NOMIDXXXXXXX
PSTPIP1 – Pyogenic Sterile Arthritis, Pyoderma Gangrenosum, and Acne Syndrome (PAPA)XXXXXXX
TNFRSF1A – Tumor Necrosis Factor (TNF) – Associated Periodic Syndrome (TRAPS)XXXXXXX
ELANE - Cyclic neutropeniaX XXXXX
ABCB1 – Inflammatory bowel disease 13  X     
ACP5 - Spondyloenchondrodysplasia with immune dysregulation    X  
ADAM17 - Inflammatory skin and bowel disease, neonatal 1   X   
Aicardi-Goutieres syndromes (AGS) - TREX1 (AGS1), RNASEH2B (AGS2), RNASEH2C (AGS3), RNASEH2A (AGS4), SAMHD1 (AGS5), ADAR (AGS6), and IFIH1 (AGS7)    X  
AP1S3 - Pustular psoriasis (PSORS15) XX    
ATG16L1 – Increased risk for Crohn’s disease X     
CARD14 – Familial psoriasis (PSORS2)XXXXXX 
CECR1/ADA2 – Deficiency of adenosine deaminase 2 (DADA2), aka Fever with early onset stroke (FEOS)X XX   
COPA - COPA syndrome, aka Autoimmune interstitial lung, joint, and kidney disease X X   
DDX58 - Singleton-Merten syndrome
FOXP3 - IPEX syndromeX      
GCH1 - Dopa-responsive dystonia, Tetrahydrobiopterin deficiencyX      
HAX1 - Severe congenital neutropenia  X    
HLA-C - Psoriasis susceptibility 1, Human immunodeficiency virus type 1, susceptibility to X     
HTR1A - Periodic fever, menstrual cycle-dependent (PFMC)X      
IL10, IL10RA, IL10RB – Early-onset inflammatory bowel disease (EO-IBD25, EO-IBD28, and EO-IBD with Il-10 deficiency)XXXX   
IL1RN – Deficiency of interleukin-1ß (IL-1ß) receptor antagonist (DIRA)XXXXX  
IL23A – Risk for inflammatory demyelinating diseases X     
IL23R – Risk for: ankylosing spondylitis, Crohn’s, psoriatic arthritis, ulcerative colitis, psoriasis X     
IL36RN – Deficiency of interleukin-36-receptor antagonist (DITRA)XXXXXX 
IL6 – Risk for juvenile rheumatoid arthritis, type 1 diabetes, inflammatory bowel disease 1 X     
IRF5 – Risk for autoimmune disorders: lupus, rheumatoid arthritis, systemic scleroderma, ulcerative colitis X     
IRGM – Risk for Crohn’s disease X     
ISG15 - Immunodeficiency 38 with basal ganglia calcification (IMD38)    X  
NCSTN – Hidradenitis suppurativa X     
NEFL - Charcot-Marie-tooth diseaseX      
NFAT5 - NFAT5 haploinsufficiency   X   
NLRC4 – NLRC4 Macrophage activation-like syndrome (NLRC4-MAS) XXX   
NLRP7 - Recurrent hydatidiform moleX X    
NLRP12 – Familial cold autoinflammatory syndrome 2 (FCAS2)XXXXXX 
NOD2 – Blau syndromeXXXXXX 
ORAI1 - Myopathy, tubular aggregate, 2 (TAM2), Immunodeficiency 9 (IMD9)X      
PLCG2 – PLCG2-associated antibody deficiency & immune dysregulation (PLAID) or Familial atypical cold urticaria (FACU) or FCAS3 and APLAIDXXXXX  
PSENEN - Hidradenitis suppurativa X     
PTPN2 – Risk for ulcerative colitis X     
RBCK1 - Polyglucosan body myopathy 1 with or without immunodeficiency (PGBM1), HOIL-1 deficiency
X XX   
SCO2 - Myopia 6 (MYP6), Cardioencephalomyopathy, fatal infantile, due to cytochrome c oxidase deficiency 1 (CEMCOX1)X      
SH3BP2 – CherubismX XX   
SLC19A3 - Biotin-thiamine-responsive basal ganglia diseaseX      
SLC25A19 - Amish lethal microcephaly. Leigh syndromeX      
SLC29A3 – SLC29A3 Spectrum disorder, aka H. syndrome; Pigmented hypertrichosis with insulin-dependent diabetes mellitus (IDDM)X XX   
TLR3 - Human immunodeficiency virus type 1, susceptibility toX      
TMEM173 – STING-associated vasculopathy with onset in infancy (SAVI)XXX X  
TNFAIP3 - Haploinsufficiency of A20 (HA20), aka Behcet-like familial autoinflammatory syndrome X   X 
TNFRSF11A – TNFRSF11A-associated hereditary fever disease (TRAPS11)X X    
TPK1 - Thiamine metabolism dysfunction syndrome 5, episodic encephalopathy type (THMD5)X      
TRAF3 - Herpes simplex encephalitis, susceptibility toX      
TRAF3IP2 - Psoriasis susceptibility 13, Candidiasis, familial, 8 X     
TRNT1 - Sideroblastic anemia with B-cell immunodeficiency, periodic fevers, and developmental delay (SIFD)XX   

About Benign Variant Reports

Many labs no longer report all variant or novel mutations on the initial report provided to doctors. To get the full variant report, doctors must make a request for this variant/novel report from the lab. Click here for more information.

Genetic Testing Registry

You can search this registry to find genetic testing available around the world here.

Finding Doctors

To find a doctor experienced with fever syndromes, contact the Autoinflammatory Alliance here.

Becoming an Empowered Patient: A Toolkit for the Undiagnosed

This kit put out by the Global Genes Project has everything you need to navigate the medical system when trying to find a diagnosis for any rare condition. It includes information on staying organized, how to talk to doctors, how to get your medical records, and much more.