Division of Nephrology, Department of InternFaculty of Medicine, Hacettepe University, Ankara, Turkey.
Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Turk J Med Sci. 2021 Oct 21;51(5):2364-2368. doi: 10.3906/sag-2102-13.
BACKGROUND/AIM: Compared to healthy controls, mean platelet volume (MPV) is frequently higher in patients with Familial Mediterranean fever (FMF) but lower in AA amyloidosis patients. The reason for the difference in MPV levels in FMF patients with and without AA amyloidosis is unclear. The aim of the study was to determine whether low MPV is unique to AA amyloidosis or MPV is similarly low in all glomerular diseases as a result of proteinuria and/or renal dysfunction.
We compared pre-biopsy MPV levels of patients with AA amyloidosis secondary to FMF, to MPV levels of patients with membranous glomerulonephritis, focal segmental glomerulosclerosis (FSGS) and IgA nephropathy that all present with proteinuria and renal dysfunction.
703 patients (411 male, 292 female) were included in the study. Mean age was 42.6 14.3 years. There were 124 patients with AA amyloidosis, 224 patients with IgA nephropathy, 188 patients with membranous glomerulonephritis, and 167 patients wit h FSGS. Patients with AA amyloidosis had lower MPV levels compared to patients without AA amyloidosis (7.9 1.2 fL vs. 8.2 0.9 fL respectively, p = 0.008). Patients with AA amyloidosis had significantly lower MPV compared to patients with each of the othe r diagnoses. Independent predictors of MPV were platelet count (β = –0.321, p < 0.001) and CRP (β = – 0.134, p < 0.03).
This study is the largest study of MPV in patients with biopsy proven AA amyloidosis and confirms previous studies reporting low MPV in AA amyloidosis. This study indicates that low MPV in AA amyloidosis cannot be explained with proteinuria and renal dysfunction.
背景/目的:与健康对照组相比,家族性地中海热(FMF)患者的平均血小板体积(MPV)通常较高,但 AA 淀粉样变性患者的MPV 较低。导致 FMF 患者有无 AA 淀粉样变性时 MPV 水平差异的原因尚不清楚。本研究旨在确定低 MPV 是否仅见于 AA 淀粉样变性,还是由于蛋白尿和/或肾功能障碍,所有肾小球疾病的 MPV 均相似降低。
我们比较了继发于 FMF 的 AA 淀粉样变性患者的活检前 MPV 水平与伴有蛋白尿和肾功能障碍的膜性肾小球肾炎、局灶节段性肾小球硬化(FSGS)和 IgA 肾病患者的 MPV 水平。
本研究共纳入 703 例患者(411 例男性,292 例女性),平均年龄为 42.6 14.3 岁。124 例患者为 AA 淀粉样变性,224 例为 IgA 肾病,188 例为膜性肾小球肾炎,167 例为 FSGS。与无 AA 淀粉样变性的患者相比,AA 淀粉样变性患者的 MPV 水平较低(7.9 1.2 fL 与 8.2 0.9 fL,p = 0.008)。AA 淀粉样变性患者的 MPV 明显低于其他每种诊断的患者。MPV 的独立预测因子为血小板计数(β = –0.321,p < 0.001)和 CRP(β = – 0.134,p < 0.03)。
本研究是最大规模的 AA 淀粉样变性患者活检 MPV 研究,证实了先前报道的 AA 淀粉样变性患者低 MPV 的研究。本研究表明,AA 淀粉样变性中的低 MPV 不能用蛋白尿和肾功能障碍来解释。