Kartal Dr. Lutfi Kirdar City Hospital, Rheumatology Clinic, Istanbul, Turkey.
Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey.
Rheumatol Int. 2022 Sep;42(9):1573-1578. doi: 10.1007/s00296-022-05156-7. Epub 2022 Jun 8.
Although it is assumed that cold exposure triggers inflammation in patients with familial Mediterranean fever (FMF), seasonal differences in FMF have not yet been investigated. This study aims to investigate the association of seasonal changes with the frequency of attacks, disease severity, and subclinical inflammation in FMF. This longitudinal study examined adult patients with FMF on an established treatment followed up for at least 1 year in Istanbul. Clinical characteristics, medications, intraseasonal attacks counts, arthralgia and arthritis, disease severity, and the subclinical inflammation parameters were recorded covering four seasons. Friedman's and Cochran's Q tests were used to analyze changes in the above-mentioned data over seasons. Additionally, all attacks experienced in each season were added, and interseasonal differences were compared with the Chi-square goodness-of-fit test. Data for 240 observations (60 patients) were analyzed. The mean age and disease duration were 39.78 (SD 11.91) and 10 (IQR 6-22.75) years, respectively. The comparison of medians for four seasons did not show any statistical differences in terms of attack frequency, disease severity parameters, markers of subclinical inflammation, and the presence of arthralgia and arthritis. The total number of intraseasonal attacks experienced by patients differed among the seasons (p = 0.023), with a higher count in winter. Adult individuals with established FMF are more likely to experience attacks in winter than summer, but this difference may not be seen in the general parameters of disease activity/severity. This result supports the notion that there is a pronounced residual activity in winter.
尽管人们认为寒冷暴露会引发家族性地中海热（FMF）患者的炎症，但 FMF 的季节性差异尚未得到研究。本研究旨在调查季节性变化与 FMF 发作频率、疾病严重程度和亚临床炎症之间的关联。这项纵向研究在伊斯坦布尔对接受既定治疗的成年 FMF 患者进行了检查，这些患者的随访时间至少为 1 年。临床特征、药物、季节内发作次数、关节痛和关节炎、疾病严重程度和亚临床炎症参数在四个季节中均有记录。使用 Friedman 和 Cochran Q 检验分析了上述数据随季节的变化。此外，还对每个季节经历的所有攻击进行了加总，并使用卡方拟合优度检验比较了季节间的差异。对 240 次观察（60 例患者）的数据进行了分析。平均年龄和疾病持续时间分别为 39.78（SD 11.91）岁和 10（IQR 6-22.75）年。四个季节中位数的比较显示，在发作频率、疾病严重程度参数、亚临床炎症标志物以及关节痛和关节炎的存在方面，均无统计学差异。患者在季节间经历的季节内发作总数存在差异（p=0.023），冬季发作次数更高。患有既定 FMF 的成年人在冬季比夏季更有可能发作，但这种差异在疾病活动/严重程度的一般参数中可能不会出现。这一结果支持了冬季仍有明显残留活动的观点。
