AB0032 ASSESSMENT OF AUTONOMIC DYSFUNCTION AND ITS RELATIONS WITH CLINICAL PARAMETERS IN FAMILIAL MEDITERRANEAN FEVER (FMF)
Authors: I. Kalkan, M. T. Duruöz
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Objectives:</h3> It was aimed to determine the symptoms and signs of autonomic dysfunction in patients with a diagnosis of Familial Mediterranean Fever (FMF), and to examine the demographic, clinical, and functional parameters that may be related. <h3>Methods:</h3> Thirty patients with similar demographic characteristics and 30 healthy controls were included in the cross-sectional study. Disease-specific parameters [disease duration, drugs, colchicine dose, Pras disease activity score, the number of attacks in last year, family history, genetic mutation type, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), systemic immune-inflammation index (SII), and signs of attack] were recorded in the patient group and quality of life was evaluated with Familial Mediterranean Fever Quality of Life Scale - FMF-QoL. Composite Autonomic Symptom Score-31 (COMPASS-31), Hospital Anxiety and Depression Scale (HADS), Fatigue Severity Scale (FSS), Jenkins Sleep Scale (JSS), Fibromyalgia Rapid Screening Tool (FIRST) were recorded in both groups. The parasympathetic nervous system (PNS) was evaluated by R-R interval variability (RRIV) during normal and deep breathing and 30:15 ratio tests with electromyography (EMG), while the sympathetic nervous system (SNS) was assessed by sympathetic skin response (SSR), blood pressure response to standing and sustained handgrip tests. <h3>Results:</h3> A total of 30 FMF patients (% 43.3 female) with a mean age of 34.53 (SD: 11.46) years and a disease duration of 14.58 (SD: 9.36) years and 30 healthy controls were included in the study. Twenty-two (73.3%) of the patients also had a positive family history. While 28 patients were using only colchicine, 2 patients were using IL-1 inhibitor in addition to colchicine due to the high disease activity. The mean colchicine dose was 1.55 (SD: 0.46) mg, the mean Pras disease activity score was 5.10 (SD: 1.56) and the average number of attacks in the last year was 7.30 (SD: 9.22). The patient group had significantly higher scores in the total COMPASS-31 autonomic symptom score and secretomotor system, gastrointestinal system, bladder functions, and pupillomotor changes sub-areas compared to the control group (Table 1). In the patient group, RRIV during normal breathing was found to be significantly lower than in the control group (Table 2) which indicates parasympathetic dysfunction. PNS and SNS comparisons are represented in Tables 2 and 3. Significant positive correlations were observed between COMPASS-31 and age, FMF-QoL, HADS, FSS, JSS, and FIRST. Significant negative correlations were found between RRIV during normal breathing and CRP, between blood pressure response to sustained handgrip test and CRP, between SSR parameters and the number of attacks in last year, CRP, HADS, FSS, between blood pressure response to standing test and JSS (p&lt;0.05). <h3>Conclusion:</h3> Our findings show that autonomic dysfunction symptoms increase in patients with FMF, and PNS dysfunction may occur due to the decrease in RRIV during normal breathing. In addition, clinical and functional parameters are associated with autonomic dysfunction symptoms and signs in the patient group. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Imran Kalkan: None declared, Mehmet Tuncay Duruöz Abvie, Novartis, Lilly, Kocak Pharma.