1
|
Liu T, Yang W, Zheng X. Familial Mediterranean fever concurrent with autoimmune glial fibrillary acidic protein astrocytopathy in a young adult. CNS Neurosci Ther 2024; 30:e14542. [PMID: 37997570 PMCID: PMC11017397 DOI: 10.1111/cns.14542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Affiliation(s)
- Tingting Liu
- Department of Critical Care Medicine, The First Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| | - Wu Yang
- Department of Critical Care Medicine, The First Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| | - Xia Zheng
- Department of Critical Care Medicine, The First Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| |
Collapse
|
2
|
Topcuoglu MA, Ayvacioglu-Cagan C, Arsava EM, Acar-Ozen P, Kalyoncu U, Gocmen R, Akbaba TH, Balcı-Peynircioğlu B, Tuncer MA. Acute stroke in familial Mediterranean fever: An analysis of 23 new cases and systematic review of the literature. Int J Rheum Dis 2023; 26:657-666. [PMID: 36744553 DOI: 10.1111/1756-185x.14588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The nature of neurovascular involvement in cases of familial Mediterranean fever (FMF) has not been adequately clarified. METHODS AND PATIENTS Clinical features, infarct topography, vascular status, and stroke etiology were prospectively determined in 35 acute neurovascular events that occurred in 23 FMF patients. Clinicoradiological features were compared with an age- and gender-matched control group of 115 acute stroke patients. Characteristics of additional FMF and acute stroke cases (6 episodes in 6 patients) identified from a systematic literature review (PROSPERO registration no: CRD420212264820) were also analyzed. RESULTS There were 27 acute ischemic stroke episodes in 19 patients, 7 transient ischemic attack episodes in 3 patients, and 1 patient with a single episode of parietal hematoma in our cohort. Twenty (74%) ischemic stroke episodes in 12 patients were cryptogenic. Ten of these 12 cases had a previous FMF diagnosis and were taking colchicine. There was no significant difference in the FMF group in terms of the presence of vascular risk factors and angiography-documented disease in comparison to controls. Cerebral distal artery involvement was significantly prevalent in FMF (78% vs 45%, P = .002). Especially, midbrain central deep perforating territory involvement was higher (30% vs 1%, P < .001). The long-term prognosis (median 8.5 years) under antiplatelet agents and colchicine is favorable. DISCUSSION The acute stroke phenotype in FMF cases is herein described for the first time. Several clinicoradiological features such as thrombotic lacunar infarcts located in the central mesencephalon seem so typical that we recommend searching for FMF mutations in geographic regions where FMF is common.
Collapse
Affiliation(s)
- Mehmet Akif Topcuoglu
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Cansu Ayvacioglu-Cagan
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Ethem Murat Arsava
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Pınar Acar-Ozen
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Umut Kalyoncu
- Department of Internal Medicine and Rheumatology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Rahsan Gocmen
- Department of Radiology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Tayfun Hilmi Akbaba
- Department of Medical Biology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Meryem Aslı Tuncer
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| |
Collapse
|
3
|
Farag Y, Sayed S, Mostafa FA, Marzouk H, Mohamed RH, Sobhy R. Cardiac repolarization abnormalities in children with familial Mediterranean fever. Pediatr Rheumatol Online J 2022; 20:38. [PMID: 35606812 PMCID: PMC9128201 DOI: 10.1186/s12969-022-00696-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Familial Mediterranean fever (FMF) is an autoinflammatory disease that can have conduction disturbances and cardiac rhythm disorders as manifestations of cardiac involvement. The aim of the study is to assess the susceptibility of children with FMF to cardiac repolarization abnormalities and therefore arrhythmia in children with FMF. METHODS A cross sectional study conducted on 60 children had FMF and 40 age and sex matched healthy controls. Cardiac repolarization markers, cardiac dimensions and functions were assessed by electrocardiogram (ECG) and conventional echocardiography in patients and controls. RESULTS The mean ± SD age of the patients was 10.43 ± 3.472 years, corrected QT (QTc) and the ratio of peak to end T wave (Tpe) over QTc interval (Tpe /QTc) increased significantly in FMF patients more than healthy control (p value 0.023 and 0.022 respectively). P wave dispersion (Pd) was significantly higher in FMF patients with amyloidosis (p value 0.030). No significant difference was found in cardiac dimensions and functions between the two groups. We found a statistically negative correlation between Pd and age of patients at time of study, age of disease onset and age at diagnosis. On the other hand, we found a statistically significant positive correlation between Pd with number of attacks per year and disease severity score. Furthermore, Tpe/QTc ratio correlated with FMF 50 score, QTc correlated with 24 hours proteinuria. QT, JT intervals correlated with fibrinogen. CONCLUSIONS FMF Patients may have increased risk of arrhythmia and should be monitored on regular basis. Compliance to colchicine therapy and better disease control might play a role in decreasing this risk.
Collapse
Affiliation(s)
- Yomna Farag
- grid.7776.10000 0004 0639 9286Pediatrics department, Faculty of Medicine, Cairo University, 4 extension of Nobar Street, Cairo, Egypt
| | - Shaimaa Sayed
- Pediatrics department, Faculty of Medicine, Cairo University, 4 extension of Nobar Street, Cairo, Egypt.
| | - Fatma Alzhraa Mostafa
- grid.7776.10000 0004 0639 9286Pediatrics department, Faculty of Medicine, Cairo University, 4 extension of Nobar Street, Cairo, Egypt
| | - Huda Marzouk
- grid.7776.10000 0004 0639 9286Pediatrics department, Faculty of Medicine, Cairo University, 4 extension of Nobar Street, Cairo, Egypt
| | - Raghda H. Mohamed
- grid.419725.c0000 0001 2151 8157Pediatrics department, National Research Center, Cairo, Egypt
| | - Rodina Sobhy
- grid.7776.10000 0004 0639 9286Pediatrics department, Faculty of Medicine, Cairo University, 4 extension of Nobar Street, Cairo, Egypt
| |
Collapse
|
4
|
Moon J. Rare genetic causes of meningitis and encephalitis. ENCEPHALITIS 2022; 2:29-35. [PMID: 37469651 PMCID: PMC10295911 DOI: 10.47936/encephalitis.2021.00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/15/2021] [Accepted: 12/24/2021] [Indexed: 07/21/2023] Open
Abstract
Differential diagnosis of meningitis and encephalitis is often very challenging because it cannot be determined based on symptoms, and the diseases have various causes. This article explains rare genetic causes of meningitis and encephalitis. Autoinflammatory disorders include cryopyrin-associated periodic syndromes, familial Mediterranean fever, and tumor necrosis factor receptor-associated periodic syndrome. Furthermore, other genetic disorders, such as complement factor I deficiency, phosphatidylinositol glycan anchor biosynthesis class T mutation, and neuronal intranuclear inclusion disease, can present as meningitis and encephalitis.
Collapse
Affiliation(s)
- Jangsup Moon
- Rare Disease Center, Departments of Genomic Medicine and Neurology, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
5
|
Neurological and neurodevelopmental symptoms in children with familial Mediterranean fever and their siblings. Eur J Pediatr 2022; 181:973-978. [PMID: 34652509 DOI: 10.1007/s00431-021-04286-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/23/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
Familial Mediterranean fever is a common autoinflammatory disease characterized by periodic attacks of fever and serositis. There are few reports describing neurological symptoms in patients with FMF. The aim of this study was to systematically assess the neurologic and developmental involvement in pediatric patients with FMF. Between the years 2016 and 2019, parents of children with FMF were asked to complete a questionnaire regarding the presence of neurological and developmental symptoms in their children with and without FMF. Demographic data, clinical characteristics, and disease course of FMF patients were collected from the medical charts. Neurodevelopmental manifestations were compared between the children with FMF and their siblings. A total of 205 children were enrolled (11.6 ± 4.7 years of age): 111 children with FMF and 94 healthy siblings in the control group. Neurological morbidity was frequently reported in children with FMF: 44 (40%) had recurrent headaches, 31 (28%) ADHD symptoms, 27 (24%) learning disabilities, and 10 (9%) febrile convulsions. Headaches and febrile convulsions were significantly more prevalent in children with FMF as compared to their siblings (ps < 0.05). ADHD and learning disabilities were associated with poor adherence to colchicine treatment.Conslusions: The present study found an increased prevalence of ADHD, learning disabilities, headaches, and febrile seizures in children with FMF. The findings underscore the importance of addressing the neurodevelopmental domain in children with FMF. In addition, detection and treatment of ADHD and learning disabilities could improve adherence with therapy and control of the underlying disease. What is Known: • Familial Mediterranean fever (FMF) is the most common inherited auto-inflammatory disease, characterized by recurrent attacks of fever, serositis, and arthritis. • Some previous case reports also described rare neurological manifestations in children with FMF. What is New: • The study found an increased prevalence of headaches, febrile seizures, ADHD, and learning disabilities, in children with FMF. • The findings underscore the importance of addressing the neurological domain in this population, which could potentially improve adherence with therapy and control of the underlying disease.
Collapse
|
6
|
Ahmed MH, Ibrahim AM, Ragab SM, Mahros AM. Musculoskeletal and neurological manifestations in a cohort of Egyptian Familial Mediterranean fever patients: genotype-phenotype correlation. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2022. [DOI: 10.1186/s43166-021-00106-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Familial Mediterranean Fever (FMF) is a periodic auto-inflammatory disease with multiple systemic manifestations. This study aims to describe the various musculoskeletal and neurological manifestations in a cohort of Egyptian FMF patients and to evaluate their relation to the different Mediterranean fever gene (MEFV) mutations.
Results
This study involved 145 FMF patients, of them 62.1% were females and 31.7% were of the pediatric age. All involved patients had homozygous MEFV gene mutation. The presenting manifestation in 71.9% of these patients was abdominal pain followed by musculoskeletal manifestations in 35.2% of them. 38.6 % of the involved patients had arthritis during the period of follow-up. Monoarthritis was the most frequent pattern of arthritis. Arthralgia was present in 96.6% of the studied patients. Myalgia was present in 19.3% of the studied patients especially involving the lower limb muscles with one case of protracted febrile myalgia. Neurological manifestations were present in about 86.9 % of patients with vertigo, paresthesia, and seizures as the most common. Five major MEFV gene mutations were found in most of the studied patients (135 patients): M694V, M680I, E148Q, V726A, and M694I. When a comparative study was done between these five major mutations according to the age of onset of the symptoms, different musculoskeletal and neurological manifestations, ESR, serum amyloid level and dose of colchicine, no statistical difference was found.
Conclusion
Musculoskeletal manifestation is the second most common presenting symptom in a cohort of Egyptian FMF patients after abdominal pain. Arthralgia is the most frequent musculoskeletal manifestation while monoarthritis of the knee or ankle joint is the most common pattern of arthritis in FMF patients. Vertigo, paresthesia, and seizures are the most frequent neurological manifestations. Musculoskeletal manifestations, neurological manifestations, serum amyloid level, and dose of colchicine are not related to the type of the genetic mutation in this cohort.
Collapse
|
7
|
Lindahl H, Bryceson YT. Neuroinflammation Associated With Inborn Errors of Immunity. Front Immunol 2022; 12:827815. [PMID: 35126383 PMCID: PMC8807658 DOI: 10.3389/fimmu.2021.827815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/27/2021] [Indexed: 01/16/2023] Open
Abstract
The advent of high-throughput sequencing has facilitated genotype-phenotype correlations in congenital diseases. This has provided molecular diagnosis and benefited patient management but has also revealed substantial phenotypic heterogeneity. Although distinct neuroinflammatory diseases are scarce among the several thousands of established congenital diseases, elements of neuroinflammation are increasingly recognized in a substantial proportion of inborn errors of immunity, where it may even dominate the clinical picture at initial presentation. Although each disease entity is rare, they collectively can constitute a significant proportion of neuropediatric patients in tertiary care and may occasionally also explain adult neurology patients. We focus this review on the signs and symptoms of neuroinflammation that have been reported in association with established pathogenic variants in immune genes and suggest the following subdivision based on proposed underlying mechanisms: autoinflammatory disorders, tolerance defects, and immunodeficiency disorders. The large group of autoinflammatory disorders is further subdivided into IL-1β-mediated disorders, NF-κB dysregulation, type I interferonopathies, and hemophagocytic syndromes. We delineate emerging pathogenic themes underlying neuroinflammation in monogenic diseases and describe the breadth of the clinical spectrum to support decisions to screen for a genetic diagnosis and encourage further research on a neglected phenomenon.
Collapse
Affiliation(s)
- Hannes Lindahl
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
- Center for Molecular Medicine, Department of Clinical Neuroscience, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Yenan T. Bryceson
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
- Center for Hematology and Regenerative Medicine, Department of Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Brogelmann Research Laboratory, Department of Clinical Sciences, University of Bergen, Bergen, Norway
| |
Collapse
|
8
|
Renson T, Hamiwka L, Benseler S. Central nervous system manifestations of monogenic autoinflammatory disorders and the neurotropic features of SARS-CoV-2: Drawing the parallels. Front Pediatr 2022; 10:931179. [PMID: 36034552 PMCID: PMC9399631 DOI: 10.3389/fped.2022.931179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022] Open
Abstract
Central nervous system (CNS) involvement in monogenic autoinflammatory disorders (AID) is increasingly recognized and can be life threatening. Therefore, a low threshold to consider CNS disease should be maintained in patients with systemic inflammation. Hyperinflammation is also a key feature of severe acute COVID-19 and post COVID-19 entities such as multisystem inflammatory syndrome in children. Like AID, COVID-19 patients can present with severe CNS involvement. The impact of COVID-19 on AID and CNS involvement in particular is still obscure, nevertheless dreaded. In the current review, we synthesize the spectrum of CNS manifestations in monogenic AID. We explore common pathophysiological and clinical features of AID and COVID-19. Moreover, we assess the impact of immune dysregulation associated with SARS-CoV-2 infections and post COVID-19 hyperinflammation in AID. The striking commonalities found between both disease entities warrant caution in the management of AID patients during the current pandemic.
Collapse
Affiliation(s)
- Thomas Renson
- Division of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Division of Nephrology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
| | - Lorraine Hamiwka
- Division of Nephrology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Susanne Benseler
- Division of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
9
|
The risk of depression and anxiety in patients with familial mediterranean fever - a cross-sectional study. J Affect Disord 2021; 292:695-699. [PMID: 34157665 DOI: 10.1016/j.jad.2021.05.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/31/2021] [Accepted: 05/31/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Familial Mediterranean Fever (FMF) is an autosomal recessive autoinflammatory disease associated with various systemic comorbidities. Recent research regarding the association with depression and anxiety has yielded conflicting results. The current study aims were to examine whether such an association exists using big data analysis methodology. METHODS This study was conducted as a cross-sectional analysis based on the Clalit Health Services database. We compared the proportions of depression and anxiety in patients diagnosed with FMF and age- and sex- matched controls. We used the Chi-square test and T-test for univariate analysis. Multivariate logistic regression was then applied to control for possible confounding variables. RESULTS The study included 7,670 patients with FMF and 7,670 matched controls. The prevalence of both depression and anxiety was found to be higher in the FMF group as compared to controls (6.22% and 4.58%, respectively, p<0.001, and 4.93% and 3.14%, respectively, p<0.001). These proportions remained significant after adjusting for important confounders, such as smoking and socioeconomic status. LIMITATIONS Temporal association does not indicate a causal relationship, the validity of the diagnoses relies on clinical records and is not based on formal classifications or diagnostic criteria, information regarding disease duration and other parameters were not accessible. CONCLUSIONS Our data imply that FMF is independently associated with both depression and anxiety. These findings highlight the importance of raising awareness for these comorbidities.
Collapse
|
10
|
Association between familial Mediterranean fever and multiple sclerosis: A case series from the JIR cohort and systematic literature review. Mult Scler Relat Disord 2021; 50:102834. [PMID: 33609923 DOI: 10.1016/j.msard.2021.102834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Familial Mediterranean fever (FMF) is the most frequent monogenic autoinflammatory disorder; and leads to the uncontrolled production of interleukin (IL)-1β. Multiple sclerosis (MS) is an inflammatory disease of the central nervous system; and its development seems to be partly correlated with IL-1β levels. It is hypothesized that FMF could be associated with MS. We aim to describe the features of patients displaying both diseases and to investigate the MEFV mutation rate in MS patients. METHODS Patients with definite MS were retrieved from the cohort of FMF patients in the Reference Center for Rare Auto-inflammatory Diseases and Amyloidosis (CEREMAIA). We also performed a systematic literature review of articles from PubMed that were published from 1990 to 2020. RESULTS Twenty-four patients were included in the case series: five patients (1.3%) from our cohort of 364 and 19 patients from the literature. The sex ratio was 2:1. The mean age at diagnosis of FMF was 19 years old; and that for MS was 29 years old. Seven studies investigating the MEFV mutation rate in MS patients were included. Three studies found a higher mutation rate in MS patients than in the control group. CONCLUSION FMF and MS features were comparable to those of patients with unrelated diseases; and MEFV mutation carriage was not positively correlated with MS. However; MS prevalence in FMF patients was higher than was expected in a healthy population. To a lesser extent; FMF prevalence in MS patients was higher than expected in a healthy population and the difference might not be significant. These data suggest that FMF could be associated with MS; and further studies are needed to investigate a potential causal association.
Collapse
|
11
|
Salehzadeh F, Azami A, Motezarre M, Nematdoust Haghi R, Ahmadabadi F. Neurological Manifestations in Familial Mediterranean Fever: a Genotype-Phenotype Correlation Study. Open Access Rheumatol 2020; 12:15-19. [PMID: 32021503 PMCID: PMC6970254 DOI: 10.2147/oarrr.s238649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 01/04/2020] [Indexed: 11/23/2022] Open
Abstract
Background and Aims Familial Mediterranean Fever (FMF) is a periodic auto-inflammatory disease with an autosomal recessive hereditary pattern. The aim of this study is to explain the spectrum of possible neurological manifestations and its genotype-phenotype correlation in patients with familial Mediterranean fever. Methods In this case series study, data of 311 FMF patients at the FMF Registration Center in Iran (http://www.fmfiran.ir/) was studied. Patient’s information was entered into a researcher designed questionnaire. Data were analyzed by SPSS software. Results The mean age of the 181 male and 130 female patients was 23.01 years, ranging from 3–78 years old. Twelve common MEFV gene analyses were performed in 311 patients, with mutated results in 187 (60.1%) patients. The most common neurological manifestations were headache in 47.26%; 64.1% of those were persistent and 35.9% had a recurrent nature. Other neurological manifestations were vertigo (83 patients, 26.7%), paresthesia (72 patients, 23.2%), tremor (53 patients, 17%), disorientation (40 patients, 12.9%), breath-holding (23 patients, 7.4%), migraine (19 patients, 6.1%), syncope (8 patients, 2.6%), epilepsy (7 patients, 2.3%), febrile seizure (4 patients, 1%), and ataxia (5 patients, 1.6%). There were no cases of stroke or metabolic disorders among these patients. Conclusion The prevalence of epilepsy among FMF patients was significantly higher than the general population. FMF patients with negative results for MEFV gene mutations had significant frequency of headache, paresthesia, breath-holding, and ataxia.
Collapse
Affiliation(s)
- Farhad Salehzadeh
- Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Ahad Azami
- Internal Medicine Department, Imam Khomeini Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Maryam Motezarre
- Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Roghayeh Nematdoust Haghi
- Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Farzad Ahmadabadi
- Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| |
Collapse
|
12
|
Familial Mediterranean Fever: Assessing the Overall Clinical Impact and Formulating Treatment Plans. Mediterr J Hematol Infect Dis 2019; 11:e2019027. [PMID: 31205631 PMCID: PMC6548206 DOI: 10.4084/mjhid.2019.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/07/2019] [Indexed: 12/24/2022] Open
Abstract
Recurrent self-limited attacks of fever and short-lived inflammation in the serosal membranes, joints, and skin are the leading features of familial Mediterranean fever (FMF), the most common autoinflammatory disorder in the world, transmitted as autosomal recessive trait caused by MEFV gene mutations. Their consequence is an abnormal function of pyrin, a natural repressor of inflammation, apoptosis, and release of cytokines. FMF-related mutant pyrins are hypophosphorylated following RhoA GTPases’ impaired activity and show a propensity to relapsing uncontrolled systemic inflammation with inappropriate response to inflammatory stimuli and leukocyte spread to serosal membranes, joints or skin. Typical FMF phenotype 1 consists of brief episodes of inflammation and serositis, synovitis, and/or erysipelas-like eruption, whereas phenotype 2 is defined by reactive amyloid-associated (AA) amyloidosis, which is the most ominous complication of FMF, in otherwise asymptomatic individuals. Furthermore, FMF phenotype 3 is referred to the presence of two MEFV mutations with neither clinical signs of FMF nor AA amyloidosis. The influence of epigenetic and/or environmental factors can contribute to the variable penetrance and phenotypic heterogeneity of FMF. Colchicine, a tricyclic alkaloid with anti-microtubule and anti-inflammatory properties, is the bedrock of FMF management: daily administration of colchicine prevents the recurrence of FMF attacks and the development of secondary AA amyloidosis. Many recent studies have also shown that anti-interleukin-1 treatment is the best therapeutic option for FMF patients nonresponsive or intolerant to colchicine. This review aims to catch readers’ attention to the clinical diversity of phenotypes, differential diagnosis, and management of patients with FMF.
Collapse
|
13
|
Abstract
Familial Mediterranean Fever (FMF) is the oldest and the most frequent of all described hereditary periodic fever syndromes. The populations originating from Mediterranean basin carry the highest risk for FMF however it is being increasingly recognized in many parts of the world. It is an autoinflammatory disease with an autosomal recessive transmission. In the majority of the patients it is related with mutations in the MEFV gene that encodes a protein named pyrin. This protein has been shown to act as a regulator of inflammation mediated by IL-1β, which plays a major role in the pathogenesis of FMF. Approximately one-third of the patients have either a single or no mutation which raise questions about its mode of inheritance. FMF is a clinical diagnosis and characterized by self-limited bouts of fever and serositis. The main long-term complication of the disease is AA amyloidosis. The mainstay of treatment is life-long colchicine given daily to prevent the recurrence of febrile attacks and the development of amyloidosis. Patients with insufficient response to colchicine may be treated with anti IL-1 agents.
Collapse
|
14
|
Magaki S, Parks R, Vinters HV, Khanlou N. A 44-Year-Old Female with Familial Mediterranean Fever, Cardiomyopathy and End Stage Renal Disease. Brain Pathol 2018; 28:135-136. [PMID: 29265632 DOI: 10.1111/bpa.12581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Shino Magaki
- Section of Neuropathology, Brain Research Institute, Ronald Reagan University of California, Los Angeles, CA
| | - Robyn Parks
- Department of Pathology and Laboratory Medicine, Brain Research Institute, Ronald Reagan University of California, Los Angeles, CA
| | - Harry V Vinters
- Section of Neuropathology, Brain Research Institute, Ronald Reagan University of California, Los Angeles, CA.,Department of Neurology, Brain Research Institute, Ronald Reagan University of California, Los Angeles, CA.,Los Angeles (UCLA) Medical Center and David Geffen School of Medicine, Brain Research Institute, Ronald Reagan University of California, Los Angeles, CA
| | - Negar Khanlou
- Section of Neuropathology, Brain Research Institute, Ronald Reagan University of California, Los Angeles, CA
| |
Collapse
|
15
|
Yusef D, Khasawneh W. Familial Mediterranean Fever Presenting with Recurrent Aseptic Meningitis: A Case Report. Pediatr Neonatol 2017; 58:378-379. [PMID: 27622671 DOI: 10.1016/j.pedneo.2016.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 03/30/2016] [Indexed: 11/17/2022] Open
Affiliation(s)
- Dawood Yusef
- Pediatric Department, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan.
| | - Wasim Khasawneh
- Pediatric Department, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan
| |
Collapse
|
16
|
Çetin G, Utku U, Atilla N, Gişi K, Sayarlioğlu M. Changes in Cerebral Blood Flow in Patients with Familial Mediterranean Fever. Noro Psikiyatr Ars 2017; 54:105-107. [PMID: 28680306 DOI: 10.5152/npa.2016.12396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 02/08/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION It is known that there is a relationship between systemic inflammation and atherosclerosis. Atherosclerosis is one of the best-known causes of cerebrovascular diseases. The aim of this study was to assess cerebral blood flow velocity using transcranial Doppler (TCD) ultrasonography in patients with familial Mediterranean fever (FMF). METHODS A total of 30 patients aged from 20 to 50 years with FMF were enrolled in the FMF group consecutively. The control group (non-FMF group) consisted of 30 age- and sex-matched randomly selected patients without FMF who had other diagnoses such as fibromyalgia and did not have risk factors for atherosclerosis. Bilateral peak-systolic, end-diastolic, and mean blood flow velocities in the middle cerebral artery (MCA), values of Gosling's pulsatility index, and values of Pourcelot's resistance index were recorded using TCD ultrasonography by a neurosonologist blinded to the FMF and control groups. RESULTS There were 30 participants in the FMF group in remission (male/female: 4/26, mean age: 34.7±5.9 years) and 30 participants in the control group (male/female: 4/26, mean age: 32.3±4.7 years). C-reactive protein levels and bilateral blood flow velocities in the MCA were significantly higher in the FMF group than in the control group. CONCLUSIONS This study suggests that persistent clinical and subclinical inflammation in patients with FMF causes an increase in cerebral blood flow velocities. Our findings provide an insight into this association between FMF and cerebrovascular diseases.
Collapse
Affiliation(s)
- Gözde Çetin
- Department of Internal Diseases, Division of Rheumatology, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Uygar Utku
- Department of Neurology, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Nurhan Atilla
- Department of Chest Diseases, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Kadir Gişi
- Department of Internal Diseases, Division of Rheumatology, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Mehmet Sayarlioğlu
- Department of Internal Diseases, Division of Rheumatology, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| |
Collapse
|
17
|
Yılmaz S, Çiğdem B, Gökçe ŞF, Ceyhan-Doğan S, Balaban H. Severity and frequency of restless legs syndrome in patients with familial Mediterranean fever. J Int Med Res 2017; 45:1340-1346. [PMID: 28606022 PMCID: PMC5625534 DOI: 10.1177/0300060517704789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objective: Restless legs syndrome (RLS) is a common sensory motor disorder. RLS an urge to move the extremities that may be accompanied by dysesthesias, and significantly affects quality of life of affected patients. The frequency of RLS is higher in different systemic inflammatory diseases. Familial Mediterranean fever (FMF) is an inherited inflammatory disease characterized by attacks of polyserositis, arthritis, and fever. The prevalence of RLS in patients with FMF is unknown. This study aimed to evaluate the prevalence rate of RLS in a sample of patients with FMF and compare this prevalence with that of a matched normal population. Method: A total of 60 patients with FMF and 60 healthy controls were studied. All participants underwent a neurological examination. Diagnostic criteria as proposed by the International Restless Legs Syndrome Study Group (IRLSSG) were used to define RLS. The IRLSSG rating scale for the severity of RLS was applied to determine the severity of symptoms. Results: The prevalence of RLS was not significantly different between patients and controls. Although the mean International Restless Legs Syndrome Rating Scale (IRLSRS) scores tended to be higher in patients compared with controls, this difference was not significant. When each item of the severity scale was compared between the two groups, significantly higher scores were found in some items of the IRLSRS in patients with FMF compared with controls. Conclusion: According to this result, RLS symptoms in patients with FMF were more frequent and lasted longer than those in controls.
Collapse
Affiliation(s)
- Samet Yılmaz
- 1 Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Burhanettin Çiğdem
- 1 Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Şeyda Figül Gökçe
- 1 Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Sevil Ceyhan-Doğan
- 2 Department of Physical Medicine and Rehabilitation Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Hatice Balaban
- 1 Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey
| |
Collapse
|
18
|
Keskindemirci G, Eskikurt G, Ayaz NA, Çakan M, Ermutlu N, İşoğlu Alkaç Ü. Does familial Mediterranean fever affect cognitive function in children? Electrophysiological preliminary study. Int J Neurosci 2017; 128:10-14. [PMID: 28581880 DOI: 10.1080/00207454.2017.1338697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Familial Mediterranean fever (FMF) is a periodic autoinflammatory disease with subclinical inflammation occurring between attacks. The aim of the study was to prospectively evaluate the cognitive function of children diagnosed with FMF that were under colchicine therapy and compare them with healthy controls through electrophysiologically event-related potentials (ERPs) study. METHODS Twelve children with FMF and 12 healthy controls were included in the study. During the electroencephalography recordings, all participants were instructed to discriminate rare stimuli (target stimuli) from frequent stimuli (standard stimuli) by pressing a botton on a mouse immediately following the target stimulus. P300, the cognitive component of ERP, was obtained in response to target stimuli and its amplitude and latency were measured. RESULTS The amplitude of the P300 of the FMF patients was higher and the latencies of the P300 of the FMF patients were shorter than the amplitudes and latencies of control patients, respectively. The difference between the groups was statistically significant for amplitude but not for latency. CONCLUSIONS Cognitive processing reflecting allocation of attention and visual processing speed seems not to be negatively affected in FMF patients with homozygous M694V mutations undergoing colchicine treatment. As this study is unique in its evaluation of the cognitive function of children with FMF, these findings may be helpful for counseling families and patients affected by the condition.
Collapse
Affiliation(s)
- Gonca Keskindemirci
- a Pediatric Rheumatology Clinic , Kanuni Sultan Süleyman Training and Research Hospital , İstanbul , Turkey
| | - Gökçer Eskikurt
- b Department of Neuroscience , Institude of Experimental Medicine, İstanbul University , İstanbul , Turkey
| | - Nuray Aktay Ayaz
- a Pediatric Rheumatology Clinic , Kanuni Sultan Süleyman Training and Research Hospital , İstanbul , Turkey
| | - Mustafa Çakan
- a Pediatric Rheumatology Clinic , Kanuni Sultan Süleyman Training and Research Hospital , İstanbul , Turkey
| | - Numan Ermutlu
- c Department of Physiology, Faculty of Medicine , İstanbul Bilim University , İstabul , Turkey
| | - Ümmühan İşoğlu Alkaç
- d Department of Physiology, İstanbul Medical Faculty , İstanbul University , İstanbul , Turkey
| |
Collapse
|
19
|
Çomak E, Tüfekçi Ö, Kılıçbay F, Isıyel E, Sever AH, Aslanger A, Ekici B. Febrile seizures in children with familial Mediterranean fever: Coincidence or association? Eur J Paediatr Neurol 2015; 19:572-6. [PMID: 26028444 DOI: 10.1016/j.ejpn.2015.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/04/2015] [Accepted: 05/09/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Familial Mediterranean fever (FMF) is an inherited disease characterized by recurrent bouts of fever and polyserositis and caused by MEditerranean FeVer gene (MEFV) mutations. Given the febrile characteristics of the disease one would expect higher frequency of febrile seizure in this group of pediatric patients. OBJECTIVES To evaluate the frequency of febrile seizure and related factors in patients with FMF. METHODS The children with the diagnosis of FMF were enrolled in the study. Information including clinical features, type of mutation and the history of febrile seizure were all noted. RESULTS A total of 97 patients, 43 (44.3%) girls with a median age of 7.93 ± 4.05 years (2-16) and a median follow-up period of 20.65 ± 24.33 months (6-135) were included in the study. The frequency of febrile seizure in children with FMF was found as 13.4%, which is higher than the general population [p = 0.04, OR: 2.9 (95% CI: 1.0-8.5)]. The allele frequency of exon 2 mutations in MEFV genes was higher in the patients with febrile seizure (p = 0.03). Frequency of FMF related clinical findings (fever, abdominal pain, arthralgia/myalgia, arthritis, chest pain and erysipelas-like erythema) was similar between the two groups. However, frequency of headache was higher in the patients with febrile seizure (p = 0.014). CONCLUSION The frequency of febrile seizure in children with FMF was found to be higher than the general population. Although this finding may be related to high fever during FMF attacks in individuals with genetic propensity of febrile seizure, it may also be a neurologic complication of FMF.
Collapse
Affiliation(s)
- Elif Çomak
- Pediatric Nephrology and Rheumatology, Derince Training and Research Hospital, Kocaeli, Turkey.
| | - Özlem Tüfekçi
- Pediatric Hematology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Fatih Kılıçbay
- Pediatrics, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Emel Isıyel
- Pediatric Nephrology and Rheumatology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Ali Haydar Sever
- Pediatrics, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Ayça Aslanger
- Medical Genetics, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Barış Ekici
- Pediatric Neurology, Derince Training and Research Hospital, Kocaeli, Turkey
| |
Collapse
|
20
|
Somuk BT, Özer S, Soyalıc H, Sapmaz E, Goktas G, Admis A, Gurbuzler L. Vestibular evoked myogenic potentials in pediatric patients with familial Mediterranean fever. Int J Pediatr Otorhinolaryngol 2015; 79:879-882. [PMID: 25851176 DOI: 10.1016/j.ijporl.2015.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We aimed to investigate whether the chronic autoinflammatory process in familial Mediterranean fever (FMF), which affects numerous systems, results in vestibular dysfunction in pediatric patients being followed up for diagnosis of FMF using VEMP recordings. METHODS 30 patients (60 ears) diagnosed with FMF and 20 (40 ears) healthy volunteers were included in the study. Following routine ear, nose, and throat examination, transient-evoked otoacoustic emissions (TEOAE) and vestibular-evoked myogenic potential (VEMP) tests were performed. RESULTS A total of 30 FMF pediatric patients (13 male, 17 female) and 20 controls (8 male, 12 female) were included in the study. The mean age of FMF patients was 12.13 ± 2.88 years, while that of the controls was 12.90 ± 2.80 years. All of the otoacoustic emission results of the patient and control groups were "pass VEMP recordings received in both ears of patients with FMF (60 ears) and both ears of controls (40 ears). There was no statistically significant difference for latencies or amplitudes for either patients or controls (p > 0.05). CONCLUSION In order to research the effect of FMF on vestibular functions, we measured VEMP. However, we did not detect alterations of VEMP in FMF patients.
Collapse
Affiliation(s)
- Battal Tahsin Somuk
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey.
| | - Samet Özer
- Department of Pediatry, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Harun Soyalıc
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Emrah Sapmaz
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Goksel Goktas
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Ayhan Admis
- Department of Oudiology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Levent Gurbuzler
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| |
Collapse
|
21
|
La Regina M, Orlandini F, Manna R. Autoinflammatory diseases: a possible cause of thrombosis? Thromb J 2015; 13:19. [PMID: 25969671 PMCID: PMC4428094 DOI: 10.1186/s12959-015-0049-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/19/2015] [Indexed: 11/24/2022] Open
Abstract
Autoinflammatory diseases are a group of disorders due to acquired or hereditary disfunction of innate immune system and characterized by systemic or localized manifestations. The prototype is Familial Mediterranean Fever, a monogenic hereditary disorder, whose causing gene (MeFV gene) was identified in 1997 and opened the way to a new fascinanting chapter of rheumatology. A growing body of monogenic and poligenic autoinflammatory disorders has been described since then. Arterial and venous thrombosis is a common medical problem, with significant morbidity and mortality. Strong evidences from basic research and clinical epidemiological studies support the theory that inflammation and thrombosis can be associated. Because of their recurrent/chronic inflammatory nature, autoinflammatory diseases are a putative cause of thrombotic manifestations. In the present work, we reviewed the available evidences about monogenic autoinflammatory disorders, complicated by thrombotic manifestations.
Collapse
Affiliation(s)
- Micaela La Regina
- Department of Internal Medicine, Ligurian East Hospital, La Spezia, Italy
| | | | - Raffaele Manna
- Centre of Periodic Fevers - Catholic University of Rome, Rome, Italy
| |
Collapse
|
22
|
Non-canonical manifestations of familial Mediterranean fever: a changing paradigm. Clin Rheumatol 2015; 34:1503-11. [PMID: 25761640 DOI: 10.1007/s10067-015-2916-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 03/01/2015] [Indexed: 01/04/2023]
Abstract
Paroxysmal crises of fever and systemic inflammation herald familial Mediterranean fever (FMF), considered as the archetype of all inherited systemic autoinflammatory diseases. Inflammatory bouts are characterized by short-term and self-limited abdominal, thoracic, and/or articular symptoms which subside spontaneously. Erysipelas-like findings, orchitis, and different patterns of myalgia may appear in a minority of patients. In recent years, many non-classical manifestations have been reported in the clinical context of FMF, such as vasculitides and thrombotic manifestations, neurologic and sensory organ abnormalities, gastrointestinal diseases, and even macrophage activation syndrome. As FMF left unrecognized and untreated is ominously complicated by the occurrence of AA-amyloidosis, it is highly desirable that diagnosis of this autoinflammatory disorder with its multiple clinical faces can be contemplated at whatever age and brought forward.
Collapse
|
23
|
Yigit S, Tural S, Tekcan A, Tasliyurt T, Inanir A, Uzunkaya S, Kismali G. The role of IL-4 gene 70 bp VNTR and ACE gene I/D variants in Familial Mediterranean fever. Cytokine 2014; 67:1-6. [PMID: 24680475 DOI: 10.1016/j.cyto.2014.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 12/04/2013] [Accepted: 01/20/2014] [Indexed: 10/25/2022]
Abstract
Familial Mediterranean fever (FMF) is characterized by recurrent attacks of fever and inflammation in the peritoneum, synovium, or pleura, accompanied by pain. It is an autosomal recessive disease caused by mutations in the MEFV (MEditerranean FeVer) gene. Patients with similar genotypes exhibit phenotypic diversity. As a result, the variations in different genes could be responsible for the clinical findings of this disease. In previous studies genes encoding Angiotensin-Converting Enzyme (ACE) and IL-4 (Interleukin-4) were found to be associated with rheumatologic and autoimmune diseases. In the present study we hypothesized whether ACE I/D or IL-4 70 bp variable tandem repeats (VNTR) genes are associated with FMF and its clinical findings in Turkish patients. Genomic DNA obtained from 670 persons (339 patients with FMF and 331 healthy controls) was used in the study. Genotypes for an ACE gene I/D polymorphism and IL-4 gene 70 bp VNTR were determined by polymerase chain reaction with specific primers. To our knowledge, this is the first study examining ACE gene I/D polymorphism and IL-4 gene 70 bp VNTR polymorphism in FMF patients. As a result, there was a statistically significant difference between the groups with respect to genotype distribution (p<0.001). According to our results, ACE gene DD genotype was associated with an increased risk in FMF [p<0.001; OR (95%): 7.715 (4.503-13.22)]. When we examined ACE genotype frequencies according to the clinical characteristics, we found a statistically significant association between DD+ID genotype and fever (p=0.04). In addition IL-4 gene P1P1 genotype was associated with FMF (p<0.001). We propose that D allele or DD genotype of ACE gene and P1 allele or P1P1 genotype of IL-4 gene may be important molecular markers for susceptibility of FMF.
Collapse
Affiliation(s)
- Serbülent Yigit
- Gaziosmanpaşa University, Faculty of Medicine, Department of Medical Biology, Tokat, Turkey.
| | - Sengul Tural
- Ondokuz Mayis University, Faculty of Medicine, Department of Medical Biology and Genetics, Section of Medical Genetics, Samsun, Turkey.
| | - Akın Tekcan
- Ondokuz Mayis University, Faculty of Medicine, Department of Medical Biology and Genetics, Section of Medical Genetics, Samsun, Turkey.
| | - Turker Tasliyurt
- Gaziosmanpaşa University, Faculty of Medicine, Department of Internal Medicine, Tokat, Turkey.
| | - Ahmet Inanir
- Gaziosmanpaşa University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Tokat, Turkey.
| | - Süheyla Uzunkaya
- Gaziosmanpaşa University, Faculty of Medicine, Department of Internal Medicine, Tokat, Turkey
| | - Gorkem Kismali
- Ankara University, Veterinary Faculty, Department of Biochemistry, Ankara, Turkey.
| |
Collapse
|
24
|
The mirabilis period of autoimmunity. Best Pract Res Clin Rheumatol 2012; 26:1-3. [DOI: 10.1016/j.berh.2012.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 01/26/2012] [Indexed: 01/06/2023]
|