title: Sonographic assessment of spleen size in Turkish migrants with Familial Mediterranean fever in Germany.
abstract: OBJECTIVE
  Familial Mediterranean fever (FMF) can be associated with splenomegaly. Prospective quantitative data are lacking. We performed a sonographic assessment of spleen size in patients with FMF and healthy control participants to assess its diagnostic value.
  
  
  METHODS
  Patients with FMF according to the criteria of Livneh et al (Arthritis Rheum 1997; 40:1879-1885) who were in an asymptomatic interval and control participants were prospectively included in this study in Germany and underwent sonographic measurement of the spleen as well as a structured interview and a physical examination. Patients and controls were Turkish migrants.
  
  
  RESULTS
  Thirty-six patients and 27 controls were included. Patients and controls did not differ significantly in age (mean ± SD, 34.8 ± 9.7 versus 33.3 ± 10.0 years, respectively; P = .56), sex, height, weight, or body mass index (26.7 ± 4.7 versus 26.1 ± 4.3 kg/m(2); P = .63). Spleen size was greater in patients than controls in width (4.3 ± 1.0 versus 3.7 ± 0.7 cm; P = .008) and also length (12.1 ± 1.9 versus 10.5 ± 1.4 cm; P = .001). Twenty-six of 36 patients (72.2%) had a history of appendectomy compared to 3 of 27 controls (11.1%; P < .001). The combination of an enlarged spleen (length >11 cm and/or width >4 cm) gave specificity of 100% (95% confidence interval, 87%-100%) and a positive predictive value of 100% (95% confidence interval, 78%-100%) for the diagnosis of FMF in our study.
  
  
  CONCLUSIONS
  Spleen size as evaluated by sonography is larger in patients with FMF compared to healthy controls. Most patients with FMF included in this study had undergone appendectomy. Familial Mediterranean fever should be considered as a differential diagnosis in Turkish migrants in Germany if the spleen is enlarged and a history of appendectomy is reported.
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Center of Ruhr University Bochum, Herne, Germany (A.Ö., M.K., B.F.H., N.P., A.G.); Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Bergmannsheil, Ruhr University Bochum, Bochum, Germany (A.Ö.); and Department of Internal Medicine I, St Josef-Hospital, Medical Center of Ruhr University Bochum, Bochum, Germany (R.S., W.S., A.G.).
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ornek
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Center of Ruhr University Bochum, Herne, Germany (A.Ö., M.K., B.F.H., N.P., A.G.); Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Bergmannsheil, Ruhr University Bochum, Bochum, Germany (A.Ö.); and Department of Internal Medicine I, St Josef-Hospital, Medical Center of Ruhr University Bochum, Bochum, Germany (R.S., W.S., A.G.).
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kurucay
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Center of Ruhr University Bochum, Herne, Germany (A.Ö., M.K., B.F.H., N.P., A.G.); Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Bergmannsheil, Ruhr University Bochum, Bochum, Germany (A.Ö.); and Department of Internal Medicine I, St Josef-Hospital, Medical Center of Ruhr University Bochum, Bochum, Germany (R.S., W.S., A.G.).
authors.forename: Bernhard F
authors.initials: BF
authors.lastname: Henning
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Center of Ruhr University Bochum, Herne, Germany (A.Ö., M.K., B.F.H., N.P., A.G.); Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Bergmannsheil, Ruhr University Bochum, Bochum, Germany (A.Ö.); and Department of Internal Medicine I, St Josef-Hospital, Medical Center of Ruhr University Bochum, Bochum, Germany (R.S., W.S., A.G.).
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Pagonas
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Center of Ruhr University Bochum, Herne, Germany (A.Ö., M.K., B.F.H., N.P., A.G.); Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Bergmannsheil, Ruhr University Bochum, Bochum, Germany (A.Ö.); and Department of Internal Medicine I, St Josef-Hospital, Medical Center of Ruhr University Bochum, Bochum, Germany (R.S., W.S., A.G.).
authors.forename: Renate
authors.initials: R
authors.lastname: Schlottmann
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Center of Ruhr University Bochum, Herne, Germany (A.Ö., M.K., B.F.H., N.P., A.G.); Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Bergmannsheil, Ruhr University Bochum, Bochum, Germany (A.Ö.); and Department of Internal Medicine I, St Josef-Hospital, Medical Center of Ruhr University Bochum, Bochum, Germany (R.S., W.S., A.G.).
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Schmidt
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Center of Ruhr University Bochum, Herne, Germany (A.Ö., M.K., B.F.H., N.P., A.G.); Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Bergmannsheil, Ruhr University Bochum, Bochum, Germany (A.Ö.); and Department of Internal Medicine I, St Josef-Hospital, Medical Center of Ruhr University Bochum, Bochum, Germany (R.S., W.S., A.G.). arnd.giese@rub.de.
authors.forename: Arnd
authors.initials: A
authors.lastname: Giese
mesh_terms: D000328:Adult; D010505:Familial Mediterranean Fever / Q000150:complications* / Q000000981:diagnostic imaging* / Q000208:ethnology; D005260:Female; D005858:Germany; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013154:Spleen / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D013163:Splenomegaly / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000209:etiology*; D014421:Turkey / Q000208:ethnology; D014463:Ultrasonography / Q000379:methods*
keywords: Turkish migrants; appendectomy; familial Mediterranean fever; gastrointestinal ultrasound; sonography; spleen size