Marzouk Huda, Mostafa Noha, Khalifa Iman, Badawi Nora, Mohamed Fathy Sabry Nahla Ibrahim
Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Pediatrics, Faculty of Medicine, Helwan University, Cairo, Egypt.
Curr Rheumatol Rev. 2020;16(4):298-303. doi: 10.2174/1573397116666200312142709.
Familial Mediterranean fever (FMF) is an autoinflammatory disease with potentially devastating effects on the kidney, and the chronic subclinical inflammation may also be deleterious. Further, proteinuria has been associated with chronic inflammatory states.
We aimed to probe whether red cell distribution width (RDW) can be used as a reliable indicator of subclinical disease in FMF patients.
Ninety-nine children with FMF, according to the new pediatric FMF criteria, were included in the present study. All were attack-free at the time of the study. They were compared with 44 healthy age-matched controls. For all patients and controls, the following tests were done: Complete blood count (in the form of red cell count, leukocyte count, platelet count, hemoglobin, RDW and MCV), CRP, ESR, creatinine and an estimated glomerular filtration rate (e-GFR). For patients, serum and urine albumin and albumin/creatinine ratio were also determined. Group 1 consisted of 61 patients, who were not suffering from microalbuminuria, and Group 2 consisted of 38 patients who had confirmed albuminuria.
RDW and ESR were significantly higher in patients with FMF without microalbuminuria than in controls, while MCV was smaller in controls (p<0.05).
RDW can be used as an indicator of subclinical inflammation in children with FMF. The tests are easy to perform and cheaper than more sophisticated tests. Microalbuminuria may be silent and occur on the background of normal levels of acute-phase reactants. All cases must be routinely checked for microalbuminuria.
家族性地中海热（FMF）是一种自身炎症性疾病，对肾脏可能产生毁灭性影响，慢性亚临床炎症也可能有害。此外，蛋白尿与慢性炎症状态有关。
我们旨在探究红细胞分布宽度（RDW）是否可作为FMF患者亚临床疾病的可靠指标。
根据新的儿科FMF标准，99名患有FMF的儿童被纳入本研究。在研究时所有患儿均未发作。将他们与44名年龄匹配的健康对照进行比较。对所有患者和对照进行以下检查：全血细胞计数（以红细胞计数、白细胞计数、血小板计数、血红蛋白、RDW和平均红细胞体积的形式）、CRP、ESR、肌酐和估计肾小球滤过率（e-GFR）。对于患者，还测定了血清和尿白蛋白以及白蛋白/肌酐比值。第1组由61名未患微量白蛋白尿的患者组成，第2组由38名已确诊白蛋白尿的患者组成。
无微量白蛋白尿的FMF患者的RDW和ESR显著高于对照组，而对照组的平均红细胞体积较小（p<0.05）。
RDW可作为FMF患儿亚临床炎症的指标。这些检查易于进行且比更复杂的检查便宜。微量白蛋白尿可能不明显，且在急性期反应物水平正常的背景下发生。所有病例都必须常规检查微量白蛋白尿。
