title: The significance of urinary beta-2 microglobulin level for differential diagnosis of familial Mediterranean fever and acute appendicitis.
abstract: The clinical and laboratory parameters widely used are not specific to discriminate the abdominal pain due to FMF attack from that of acute appendicitis. The present study aims to investigate the urinary beta-2 microglobulin (U-β2M) level as a potential parameter to identify these two diseases mimicking each other. A total of 51 patients with established FMF diagnosis due to Tel Hashomer criteria on colchicine treatment (1-1.5 mg/day), 15 patients with acute appendicitis who had appropriate clinical picture and were also supported pathologically after the surgery, and 20 healthy controls were enrolled in the study. Of the 51 patients with FMF, 25 were at an attack period, while remaining 26 were not. For the diagnosis of acute attack, as well as physical examination, laboratory tests including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were performed. From urine specimens U-β2M, microalbumin, and N-acetyl glucosaminidase (U-NAG) were measured. U-β2M levels were significantly higher in acute appendicitis group compared to FMF attack, FMF non-attack, and control groups (p < 0.001, p < 0.001, and p < 0.001, respectively). U-NAG and microalbuminuria were significantly higher in acute appendicitis, FMF attack, and FMF non-attack groups compared to controls (U-NAG p < 0.001, p = 0.016, p = 0.004, microalbuminuria p < 0.001, p < 0.001, p < 0.001, respectively). Microalbuminuria was significantly higher in acute appendicitis group compared to the FMF attack group (p = 0.004). Determination of U-β2M levels may be helpful for differential diagnosis of peritonitis attacks of FMF patients on colchicine treatment and acute appendicitis. However, this finding should be substantiated with other studies.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, Suleyman Demirel University Faculty of Medicine, Ayazmana Mah., 4419. Cad. Metro City Vadi Evleri D Blok Daire: 16, 32000, Isparta, Turkey. dryunusugan@hotmail.com.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Ugan
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Korkmaz
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Atalay
authors.initials: A
authors.lastname: Dogru
authors.affiliation: Department of General Surgery, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Yavuz Savas
authors.initials: YS
authors.lastname: Koca
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Balkarlı
authors.affiliation: Department of Medical Biochemistry, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Firdevs
authors.initials: F
authors.lastname: Aylak
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Sevket Ercan
authors.initials: SE
authors.lastname: Tunc
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine*; D000208:Acute Disease; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis* / Q000188:drug therapy / Q000652:urine; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D003078:Colchicine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D010505:Familial Mediterranean Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000652:urine; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D014421:Turkey; D055815:Young Adult; D001613:beta 2-Microglobulin / Q000652:urine*
chemical_list: D001613:beta 2-Microglobulin; D002097:C-Reactive Protein; D000118:Acetylglucosaminidase; D003078:Colchicine
keywords: Acute appendicitis; Familial Mediterranean fever; Urinary beta-2 microglobulin