title: Disease severity in adult patients of Turkish ancestry with familial mediterranean fever living in Germany or Turkey. Does the country of residence affect the course of the disease?
abstract: BACKGROUND
  The environment may affect the course of familial Mediterranean fever (FMF).
  
  
  OBJECTIVE
  The objective of this study was to compare disease severity between adult FMF patients in Turkey (TR) and Germany (G).
  
  
  METHODS
  Adult FMF patients of Turkish ancestry on colchicine living in Turkey (n = 40) or G (n = 35) were compared. Disease severity, C-reactive protein (CRP), and erythrocyte sedimentation rate were assessed.
  
  
  RESULTS
  Groups differed significantly in the following aspects: age at onset of disease (TR: 15.6, G: 10.8 years; P = 0.02), delay between onset and initiation of colchicine treatment (TR: 6.8 years, G: 14.9 years; P < 0.001), female gender (TR: 80%, G: 57.1%; P = 0.04), and duration of disease (TR: 14.4 years, G: 23.4 years; P < 0.001). There was no significant difference in colchicine treatment concerning average dosing and duration of therapy. No significant difference could be found between the 2 groups in CRP and disease severity as assessed by the score of Pras et al. (Am J Med Genet. 1998;75:216-219) even after adjusting for potential confounding variables. Mean erythrocyte sedimentation rate was significantly higher among patients living in G (TR: 13.2 mm/first hour, G: 26.3 mm/first hour; P < 0.001). Among patients living in Germany, there was a significant difference in age at FMF onset depending on their country of birth (born in TR: 14.9 years, born in G: 6.9 years; P = 0.0001).
  
  
  CONCLUSIONS
  In adult FMF patients living in Turkey or Germany, no difference in disease activity or CRP could be found. German patients were younger at onset of disease and had a longer delay between onset and initiation of colchicine treatment.
authors.affiliation: Central Patient Admission Unit/Emergency Department, Marienhospital Herne, Ruhr-University Bochum, Herne, Germany. arnd.giese@rub.de
authors.forename: Arnd
authors.initials: A
authors.lastname: Giese
authors.forename: Ahmet
authors.initials: A
authors.lastname: Örnek
authors.forename: Levent
authors.initials: L
authors.lastname: Kilic
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kurucay
authors.forename: Süleyman Nahit
authors.initials: SN
authors.lastname: Şendur
authors.forename: Elke
authors.initials: E
authors.lastname: Lainka
authors.forename: Bernhard Ferdinand
authors.initials: BF
authors.lastname: Henning
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003078:Colchicine / Q000627:therapeutic use; D010505:Familial Mediterranean Fever / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D005858:Germany / Q000208:ethnology; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D016014:Linear Models; D008297:Male; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology / Q000208:ethnology
chemical_list: D006074:Gout Suppressants; D002097:C-Reactive Protein; D003078:Colchicine