Background
The proinflammatory cytokine IL-1β has been implicated in the pathogenesis of a number of the hereditary periodic fever syndromes. One such syndrome, Muckle–Wells syndrome (MWS), is characterised by the triad of urticaria, progressive sensorineural deafness and systemic amyloid A amyloidosis. Other features include rigors, leucocytosis, raised acute phase reactants and serum amyloid A levels. A number of case reports have recently emerged involving treatment with the recombinant human IL-1 receptor antagonist, Anakinra (Kineret; Amgen, Cambridge, UK) [1–3].