Role of fecal calprotectin in the assessment of intestinal inflammation in children with familial Mediterranean fever.

AIM

Familial Mediterranean fever (FMF) is the most common auto-inflammatory disease with recurrent fever and serositis episodes. In recent years, some cases with FMF were reported with gastrointestinal involvement without amyloidosis, vasculitis and inflammatory bowel disease (IBD). It is not yet known whether gastrointestinal involvement is a part of the disease or not. The aim of this study is to investigate the frequency of intestinal inflammation by using a noninvasive method, fecal calprotectin measurement, in pediatric FMF patients.

METHOD

Sixty-five FMF patients, 30 healthy controls and 11 patients with acute ulcerative colitis were included in the study. A standard survey inquiring gastrointestinal and other clinical symptoms was completed. The medications, MEFV mutations, whole blood count and C-reactive protein levels were recorded. Fecal calprotectin was studied with the enzyme-linked immunosorbent assay method from the feces samples of the all subjects.

RESULTS

None of the FMF patients had clinical signs of IBD. Fecal calprotectin levels of the FMF patients were found to be significantly higher than the healthy controls (174.8 ± 150.8 vs 52.9 ± 36.5, p < 0.001). Fecal calprotectin levels of the ulcerative colitis patients were significantly higher than the FMF patients (523.5 ± 183 vs 174.8 ± 150.8, p = 0.001). There was a correlation between fecal calprotectin levels and neutrophil/lymphocyte ratio (r = 0.324, p = 0.009).

CONCLUSION

Our results supported subclinical intestinal inflammation in pediatric FMF patients. Further studies are needed to clarify the reason for intestinal inflammation in FMF patients.