Pediatric Rheumatology Unit, Department of Pediatrics, School of Medicine, Akdeniz University, 07070 Antalya, Turkey.
Rheumatol Int. 2013 Feb;33(2):377-80. doi: 10.1007/s00296-012-2400-x. Epub 2012 Mar 27.
Familial Mediterranean fever (FMF) has been reported more frequently in patients presenting with Henoch-Schönlein purpura (HSP) than in the general population. But, there is no clear knowledge about MEFV mutations in patients with HSP. We investigated the prevalence of MEFV mutations in children with HSP and without FMF whether these mutations have any effect on the disease course or complications. A total of 76 children with HSP who had no typical symptoms of FMF were screened for the mutations in exon 2 and exon 10 of the MEFV gene. Eleven of 76 patients (14.4 %) were heterozygous (E148Q in 5, M694V in 4, M680I in 1, E148V in 1), 5 (6.6 %) were homozygous (M694V/M694V in 4, V726A/V726A in 1), and 2 (2.6 %) were compound heterozygous (E148Q/M694V mutations in 1 and L110P/E148Q mutations in 1). Altogether, 7 patients carried 2 mutated MEFV alleles (9.2 %), which was higher than that observed in the general Turkish population (1 %). No significant differences in joint, gastrointestinal, renal involvement, or subcutaneous edema, and also acute phase reactants including leukocyte count, erythrocyte sedimentation rate, and serum C-reactive protein concentration were found between the groups. The prevalence of the two allele-MEFV mutations in patients with HSP was found higher than that of the general population. However, it seems that MEFV gene mutations may not have any effect on the clinical presentation of HSP.
家族性地中海热(FMF)在出现过敏性紫癜(HSP)的患者中比普通人群更为常见。但是,关于 HSP 患者的 MEFV 突变尚不清楚。我们调查了 HSP 患儿中 MEFV 突变的患病率,以及这些突变是否对疾病过程或并发症有任何影响。共筛选了 76 例无 FMF 典型症状的 HSP 患儿,以检测 MEFV 基因外显子 2 和外显子 10 的突变。11 例患者(14.4%)为杂合子(5 例为 E148Q,4 例为 M694V,1 例为 M680I,1 例为 E148V),5 例(6.6%)为纯合子(4 例为 M694V/M694V,1 例为 V726A/V726A),2 例(2.6%)为复合杂合子(1 例为 E148Q/M694V 突变,1 例为 L110P/E148Q 突变)。总共有 7 例患者携带 2 个突变 MEFV 等位基因(9.2%),高于普通土耳其人群(1%)。各组间关节、胃肠道、肾脏受累及皮下水肿以及急性期反应物白细胞计数、红细胞沉降率和血清 C 反应蛋白浓度无显著差异。HSP 患者双等位基因突变的患病率高于普通人群。然而,MEFV 基因突变似乎对 HSP 的临床表现没有影响。