Increased frequency of familial Mediterranean fever in Central Anatolia, Turkey

OBJECTIVE

It has been observed that familial Mediterranean fever is more prevalent among people coming from central Anatolia in Turkey. To test this observation the frequency of FMF was investigated by afield survey in Sivas, a city located in central of Turkey.

METHODS

The survey was conducted in a cohort of 4809 persons selected by systematic sampling from 2 districts of Sivas, with a total population of 83,274. Face to face interviewing was done with registered households using a standard questionnaire developed to screen FMF A second interview was conducted by a rheumatologist and an internist of those individuals who were regarded to have possible FMF.

RESULTS

The suspicion of FMF emerged in the cases of 46 individuals during the survey and 36 were interviewed for a second time. FMF was diagnosed in 10 cases. Only one had a previous diagnosis of FMF. The overall frequency of FMF among a cohort of 3,948 inhabitants of Sivas was 1/395 (0.25%).

CONCLUSION

This study indicates that the prevalence of FMF in Sivas may be higher than that in general Turkish population, which has been reported to be 0.1%.

High-dose intravenous immune globulin in the management of severe Guillain-Barre syndrome

Guillain-Barre Syndrome (GBS) is the most common cause of acute generalized paralysis. Although the cause and pathogenesis of GBS remain unknown, there is increasing evidence to suggest that this syndrome has an immunological basis. Two children suffering from GBS were treated with high-dose intravenous immune globulin (IVIG) (1 g/kg/day over two consecutive days). Both children showed marked clinical improvement within 48 hours of the onset of treatment. It is suggested, on the basis of recent case reports, that immunoglobulins may have an important role in the treatment of Guillain-Barre Syndrome.

Effects of protein energy malnutrition on circulating thyroid hormones

The effect of protein energy malnutrition (PEM) in the children on serum levels of total thyroxine (TT4), total triodothyronine (TT3) and thyrotropin (TSH) were evaluated. There were 107 children aged 2 to 60 months in the malnutrition group and 54 healthy age and sex matched controls. Serum TT4 and TT3 were all reduced in the malnutrition group. This decrease in TT3 was more significant (p < 0.01) in severe malnutrition than in mild PEM. Serum TSH levels in the malnutrition and control groups were similar. These results suggest that the children remained euthyroid and represent an adaptive response to protein energy malnutrition.