Sav Nadide Melike, Altinsoy Hasan Baki, Türen Betül, Gökçe Ayşe
Department of Pediatric Nephrology, Duzce University, Duzce, Turkey.
Department of Radiology, VM Medical Park Bursa, Bursa, Turkey.
Pediatr Nephrol. 2025 May;40(5):1701-1709. doi: 10.1007/s00467-024-06637-6. Epub 2025 Jan 9.
Familial Mediterranean Fever (FMF) is a genetic disorder that can cause kidney damage. Shear wave elastography (SWE), a non-invasive method, was used to evaluate the decrease in renal tissue elasticity as a predictive parameter for amyloidosis. This study aimed to examine the changes in renal elasticity in patients with FMF using the renal SWE measurement method.
The present study included 50 pediatric patients diagnosed with FMF. The median SWE values of both kidneys were compared between the groups. Acute phase reactants were also evaluated.
The SWE measurements (for the left kidney p = 0.007, for the right kidney p = 0.06) and proteinuria levels (p < 0.001) of the patient group were found to be higher than those of the control group. No correlation was observed between the disease activity score and the SWE measurements. Erythrocyte sedimentation rate (p < 0.001), C-reactive protein (p < 0.001) and urine protein/creatinine ratio (p < 0.001) were significantly higher in the remission period compared to the control group, whereas estimated glomerular filtration rate was found to be low in the patient group (p < 0.001), which was considered as an indicator that subclinical inflammation continued in the course of the disease.
The acute phase reactants were elevated in patients with FMF even in the remission period which indicates that the disease is constantly active and have the potential to cause damage in all organs and tissues. It is thought that this subclinical inflammation may also contribute to increased tissue stiffness, which may serve as a predictor for the development of amyloidosis.
家族性地中海热(FMF)是一种可导致肾损伤的遗传性疾病。剪切波弹性成像(SWE)作为一种非侵入性方法,被用于评估肾组织弹性降低作为淀粉样变性的预测参数。本研究旨在使用肾脏SWE测量方法检查FMF患者的肾脏弹性变化。
本研究纳入了50例诊断为FMF的儿科患者。比较了两组患者双肾的SWE中位数。还评估了急性期反应物。
发现患者组的SWE测量值(左肾p = 0.007,右肾p = 0.06)和蛋白尿水平(p < 0.001)高于对照组。未观察到疾病活动评分与SWE测量值之间存在相关性。与对照组相比,缓解期的红细胞沉降率(p < 0.001)、C反应蛋白(p < 0.001)和尿蛋白/肌酐比值(p < 0.001)显著更高,而患者组的估计肾小球滤过率较低(p < 0.001),这被认为是疾病过程中亚临床炎症持续存在的指标。
FMF患者即使在缓解期急性期反应物也升高,这表明疾病持续活跃,有可能对所有器官和组织造成损害。据认为,这种亚临床炎症也可能导致组织硬度增加,这可能是淀粉样变性发展的一个预测指标。