Department of Pediatric Nephrology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey.
Rheumatol Int. 2011 Jun;31(6):779-84. doi: 10.1007/s00296-010-1383-8. Epub 2010 Mar 9.
Familial Mediterranean fever (FMF) is a disease characterized by recurrent, self-limiting fever and serositis and caused by altered pyrin due to mutated MEFV gene. The aim of this study was to investigate clinical manifestations and MEFV mutations among patients with FMF and healthy controls in the Aegean region of Turkey. This study included 308 patients and 164 healthy controls. Patients were divided into three groups according to Tel-Hashomer criteria; definitive, probable, and suspicious. Among the patients, 146 were women (47.4%) and 162 were men (52.6%). The mean age (±SD) of the patients at the diagnosis was 9.6±3.95 (range 0.5-18). The mean age (±SD) at onset of the symptom was 6.2±3.95 (range 1-18). Symptoms were seen earlier onset in definitive group than the suspicious group in our cohort (4.7±3.9 years, 6.6±3.9 years, respectively; P=0.001). Clinical features were abdominal pain (83.1%), fever (55%), arthritis (17.1%), myalgia (4.5%), pleuritis (10%), and erysipelas-like erythema (7.7%). Fever, arthralgia, arthritis, chest pain, and amyloidosis were found statistically significant more in definitive group than suspicious group (P<0.001, P<0.001, P<0.001, P<0.05, and P<0.001, respectively). MEFV gene mutations were identified in 199 patients (64.6%). The most commonly encountered MEFV mutation among the patients was M694V homozygote (25%). M694V homozygous mutation was found most frequently in definitive FMF group than other groups (49, 9, 8.9%, respectively). To our knowledge that FMF should be suspected in the case of non-specific but recurrent attacks of serositis and high fever, and molecular analysis should be performed in order to make diagnosis of FMF.
家族性地中海热(FMF)是一种以反复发作、自限性发热和浆膜炎为特征的疾病,由突变的 MEFV 基因导致 pyrin 改变引起。本研究旨在探讨土耳其爱琴海地区 FMF 患者和健康对照者的临床表现和 MEFV 突变。本研究纳入了 308 例患者和 164 例健康对照者。根据 Tel-Hashomer 标准,将患者分为三组:明确、可能和可疑。在患者中,146 例为女性(47.4%),162 例为男性(52.6%)。患者诊断时的平均年龄(±SD)为 9.6±3.95(范围 0.5-18)。症状发作的平均年龄(±SD)为 6.2±3.95(范围 1-18)。在本队列中,明确组的症状起始年龄早于可疑组(4.7±3.9 年,6.6±3.9 年;P=0.001)。临床特征为腹痛(83.1%)、发热(55%)、关节炎(17.1%)、肌痛(4.5%)、胸膜炎(10%)和红斑样红斑(7.7%)。发热、关节痛、关节炎、胸痛和淀粉样变性在明确组中比可疑组更常见(P<0.001,P<0.001,P<0.001,P<0.05 和 P<0.001,分别)。在 199 例患者(64.6%)中发现了 MEFV 基因突变。患者中最常见的 MEFV 突变是 M694V 纯合子(25%)。M694V 纯合突变在明确的 FMF 组中比其他组更常见(分别为 49、9、8.9%)。据我们所知,FMF 应怀疑在非特异性但反复发作的浆膜炎和高热的情况下,并应进行分子分析以作出 FMF 的诊断。