Evaluation of subclinical inflammation in familial Mediterranean fever patients: relations with mutation types and attack status: a retrospective study.
Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disease of childhood and adulthood. Development of systemic amyloidosis and frequent attack influence quality of life and survival. There is sporadic evidence indicating subclinical inflammation in patients with FMF. We aimed to assess subclinical inflammation using neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and C-reactive protein (CRP) in pediatric patients with FMF in the attack-free period. In this retrospective study, we reviewed the files of all FMF patients in our pediatric rheumatology outpatient clinic in a tertiary center and enrolled those with sufficient clinical and laboratory data. We also enrolled 73 controls. We grouped the patients according to being in attack period or attack-free period. We compared CRP, NLR, PLR, and WBC (white blood cell) levels between different mutations and polymorphisms. We also compared patients in the attack period with those in attack-free period. We enrolled 61 patients in attack period, 509 patients in attack-free period, and 73 controls. There was no difference between patients with different mutations with respect to NLR or PLR levels in the attack-free period. However, CRP levels were higher in patients with homozygous exon 10 mutations, especially those with homozygous M694V mutations compared with other mutations. However, CRP levels were mostly normal in these patients. Our data are against the reported fact that patients with FMF have higher NLR or PLR levels in attack-free periods. However, CRP levels were higher in the presence of homozygous exon 10 mutations (in particular homozygous M694V mutations).
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey. fatihmk@istanbul.edu.tr.
Fatih Mehmet
FM
Kelesoglu
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Erhan
E
Aygun
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Nazli Kubra
NK
Okumus
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Ayşenur
A
Ersoy
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Edanur
E
Karapınar
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Nesibe
N
Saglam
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Nur Gokce
NG
Aydın
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Beyza Betul
BB
Senay
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Sumeyye
S
Gonultas
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Elif
E
Sarisik
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Melike Zeynep
MZ
Can
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Sirin
S
Atay
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Dilruba
D
Basbug
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Feyza Kubra
FK
Tiryaki
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Sena
S
Ozer
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Rana Berru
RB
Durmus
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Fatih
F
Orem
Department of Pediatrics, Haseki Education and Training Hospital, Vatan Caddesi, Istanbul, 34093, Turkey.
Tugrul
T
Atay
Department of Public Health (Statistic), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.|Public Health (Statistics), Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey.
Ahmet
A
Acar
Department of Pediatrics, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Yasin
Y
Yilmaz
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Seyma
S
Kaya
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Aylin
A
Ciftkaya
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Zeynep
Z
Sarac
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Cagri Can
CC
Makar
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Basak
B
Saracoglu
Department of Pediatric Cardiology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Gafur
G
Dogdu
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Rukiye Eker
RE
Omeroglu
D000293:Adolescent; D001792:Blood Platelets; D002648:Child; D002675:Child, Preschool; D010505:Familial Mediterranean Fever / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D008214:Lymphocytes; D008297:Male; D009154:Mutation; D009504:Neutrophils; D000071198:Pyrin / Q000235:genetics*; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000071198:Pyrin
C-reactive protein; Familial Mediterranean fever; Neutrophil to lymphocyte ratio; Platelet to lymphocyte ratio; Subclinical inflammation