Department of Pediatric Rheumatology, Cukurova University Faculty of Medicine, Saricam, 01331, Adana, Turkey.
Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey.
Clin Rheumatol. 2019 Mar;38(3):921-926. doi: 10.1007/s10067-019-04452-1. Epub 2019 Jan 31.
Familial Mediterranean fever (FMF) is characterized by self-limiting fever episodes usually accompanied by serositis, arthralgia, and arthritis. Functional gastrointestinal disorders (FGIDs) are diseases in which brain-gut axis and low-grade inflammation take part in pathogenesis. We aimed to study the FGIDs frequencies and possible risk factors for FGIDs in children with FMF.
This case-control study included 103 children with FMF followed up between July 2016 and July 2018 and 100 healthy controls. Age, gender, disease characteristics, and MEFV gene results were recorded retrospectively. Laboratory parameters were obtained at the time of study enrollment. Diagnosis of FGIDs was assessed with Rome IV criteria.
The mean age at study enrollment was 12.58 ± 3.79 and 9.71 ± 3.59 years in FMF and healthy control groups, respectively. Overall FGID frequency was 39.8% (n = 41) in FMF patients and 19% (n = 19) in the control group. Functional dyspepsia and irritable bowel syndrome (particularly constipation predominant subtype) rates were statistically higher in the FMF group. In detail, genotype, age at onset, symptoms, colchicine duration, and colchicine responses did not differ between FMF patients in regard to having FGIDs.
This study showed that children with FMF may predispose to pain predominant FGIDs. We also suggest that FGIDs should be considered in FMF patients suffering recurrent abdominal pain episodes unaccompanied by APR elevation, which can be also named as incomplete FMF attacks.
家族性地中海热（FMF）的特征是自限性发热发作，通常伴有浆膜炎、关节炎和关节痛。功能性胃肠疾病（FGIDs）是一种涉及脑-肠轴和低度炎症参与发病机制的疾病。我们旨在研究 FMF 患儿 FGIDs 的频率和 FGIDs 的可能危险因素。
这项病例对照研究包括 2016 年 7 月至 2018 年 7 月期间随访的 103 例 FMF 患儿和 100 例健康对照者。回顾性记录年龄、性别、疾病特征和 MEFV 基因结果。研究入组时获得实验室参数。采用罗马 IV 标准诊断 FGIDs。
研究纳入时的平均年龄分别为 FMF 组 12.58 ± 3.79 岁和对照组 9.71 ± 3.59 岁。FMF 患者的总体 FGID 发生率为 39.8%（n=41），对照组为 19%（n=19）。FMF 组功能性消化不良和肠易激综合征（特别是便秘为主型）的发生率更高。具体而言，基因型、发病年龄、症状、秋水仙碱持续时间和秋水仙碱反应在 FMF 患者中出现 FGIDs 时无差异。
本研究表明，FMF 患儿可能易患以疼痛为主的 FGIDs。我们还建议，对于反复发作腹痛且 APR 升高不伴 FMF 发作的 FMF 患者，应考虑 FGIDs，也可将其命名为不完整的 FMF 发作。
