FRI0483 SUBCLINICAL INFLAMMATION AND RELATED PARAMETERS IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER
Authors: M. T. Duruöz, N. Öz, A. Ozer, H. H. Gezer, D. Erdem Gürsoy, S. Acer Kasman
Journal: Annals of the Rheumatic Diseases (2020)

Background: Familial Mediterranean Fever (FMF), which is more common in groups in the Mediterranean basin, is a monogenic autoinflammatory disease characterized by recurrent attacks of febrile peritonitis, pleuritis and arthritis. Objectives: In this study, we aimed to investigate the clinical, demographic and genotypic features that may be associated with subclinical inflammation in FMF and to determine the related parameters with subclinical inflammation. Methods: FMF patients according to the Tel-Hashomer criteria were included into the study. The demographic characteristics of the patients, duration of the disease, concomitant diseases, MEFV genotype mutation, colchicine use and resistance were collected. Acute-phase reactants such as white blood cell count, erythrocyte sedimentation rate, and C-reactive protein levels during the attacks and attack-free periods were noted. Subclinical inflammation was defined as the continuation of the acute phase response (CRP) between episodes. We divided study population into two groups as; patients with or without subclinical inflammation (Group 1 and Group 2, respectively) and these group were compared with the parameters described above. Patients with infectious disease (viral or bacterial) in the past two months were excluded from the study Results: Eigthy patients (72.5% female) with mean age 37.1 SD 11.2 years were recruited into the study. Twenty-three (28.7%) patients were determined with subclinical inflammation. Group 1 had significantly higher rate of concomitant rheumatic disease(i.e spondyloarthropathy), erythrocyte sedimentation rate and MEFV homozygous mutation compared with Group 2 (p&lt;0.05, for each). Disease duration, months PRASS score, FMF quality of life, age at onset of symptoms, family history of FMF, response to colchicine, attack time, attack in the last 6, delay in diagnosis parameters were not significantly different between groups (p&gt; 0.05). Conclusion: FMF patients whose elevated erythrocyte sedimentation rate and MEFV homozygous mutation should be closely monitored for subclinical inflammation even during attack-free periods. Concomitant disease should be detected in FMF patients with subclinical inflammation. References: [1]Shinawi M, Brik R, Kepten I, Berant M, Gersoni B. Familial Mediterranean fever: high gene frequency and heterogenous disease among Israeli-Moslem Arab population. J Rheumatol 2000;27:1492–5 [2]Bayram MT, Çankaya T, Bora E, Kavukçu S, Ülgenalp A, Soylu A, Türkmen M. Risk factors for subclinical inflammation in children with Familial Mediterranean fever. Rheumatol Int. 2015 Aug;35(8):1393-8. Table 1: Demographic and clinical features of the patients with familial Mediterranean fever Without Subclinical inflamation n= (57) With Subclinical inflamation n= (23) P value Age (years; mean SD) 37,78 SD 13,22 36,82 SD 10,49 0.987 Female, gender, n (%) 45(%78) 13(%56) 0.055 Disease duration (month; mean SD) 255,3 SD 195,1 180,2 SD 121,1 0.191 PRASS score (mean SD) 6,08 SD 2,15 5,36 SD 1,59 0.147 BMİ, kg/m 2 26,12 SD 4,8 32,13 SD 28,48 0.629 Current smoking status (%) 17(%29) 3(%13) 0.067 Age at onset of symptoms (month; mean SD) 15,69 SD 9,41 17,28 SD 10,34 0.54 Family history of FMF(%) 37(%64) 18(%78) 0.295 Response to colchicine(%) 6(%10) 4(%17) 0.462 Attack time (day; mean SD) 1,9 SD 1,1 2,26 SD 1,4 0,523 Attack in the last 6 months (mean SD) 2,79 SD 3,1 4,56 SD 5,5 0,184 FMF quality of life (mean SD) 31,5 SD 13,6 25.7 SD 16,4 0,130 Delay in diagnosis(month; mean SD) 12,29 SD 10,9 14,3 SD 14,9 0,840 Disclosure of Interests: None declared