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Magen E, Ozeri D, Merzon E, Vinker S, Israel A. Dermatological Comorbidities in Patients with Familiar Mediterranean Fever. Acta Derm Venereol 2024; 104:adv39988. [PMID: 39145494 PMCID: PMC11337221 DOI: 10.2340/actadv.v104.39988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 07/04/2024] [Indexed: 08/16/2024] Open
Abstract
is missing (Short communication).
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Affiliation(s)
- Eli Magen
- Leumit Health Services, Tel Aviv-Yafo, Israel; Medicine A Department, Assuta Ashdod University Hospital Faculty of Health Sciences, Ben-Gurion University, Beer-Sheba, Israel.
| | - David Ozeri
- Division of Rheumatology, Sheba Medical Center, Ramat Gan, Israel
| | - Eugene Merzon
- Leumit Health Services, Tel Aviv-Yafo, Israel; Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Shlomo Vinker
- Leumit Health Services, Tel Aviv-Yafo, Israel; Department of Family Medicine, Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Ariel Israel
- Leumit Health Services, Tel Aviv-Yafo, Israel; Department of Family Medicine, Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
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Amaryan G, Sarkisian T, Tadevosyan A, Braegger C. Familial Mediterranean fever in Armenian children with inflammatory bowel disease. Front Pediatr 2024; 11:1288523. [PMID: 38410520 PMCID: PMC10895960 DOI: 10.3389/fped.2023.1288523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/27/2023] [Indexed: 02/28/2024] Open
Abstract
Inflammatory bowel disease (IBD) and familial Mediterranean fever (FMF) are inflammatory diseases with complex interactions among genetic, immune, and environmental factors. FMF is a monogenic autoinflammatory disease, characterized by recurrent febrile attacks and polyserositis, and is manifested mainly in childhood. FMF is widespread in Armenia. There are reports on the concurrent occurrence of FMF and IBD. MEFV gene mutations may have a disease-modifying effect on IBD. We have investigated the frequency of MEFV mutations and FMF in Armenian children with IBD and their influence on the clinical course. A total of 69 untreated IBD patients under 18 years of age were enrolled: 52.1% (36) had ulcerative colitis (UC), 21.7% (15) had Crohn's disease (CD), and 26.0% (18) had unclassified colitis (IBD-U). The frequency of FMF among them was 36.2% (25/69), and MEFV mutations were identified in 53.6% (37/69). The highest rate of MEFV mutations and FMF was in UC patients (61.1% and 41.6% respectively). In all, 56.7% (21/37) of IBD patients with MEFV mutations had M694V mutated alleles, mainly in compound heterozygous and heterozygous states. There were no associations in the group of IBD patients with coexisting FMF (25), either between any MEFV mutation and type of IBD or coexistence of FMF. Overall, 36.0% (9/25) of them developed VEO IBD and carried mainly the M694V mutation. We concluded that the carrier frequency of MEFV mutations among Armenian pediatric IBD patients was rather high (53.6%), especially for UC. It was suggested that the MEFV gene is not necessarily a susceptibility gene but most likely modifies the course of IBD. MEFV genetic testing was recommended for Armenian pediatric IBD patients, especially for VEO UC and IBD-U, atypical IBD course, or resistance to the conventional treatment. They should also be asked for isolated febrile attacks, recurrent arthritis, and family history, even in the absence of FMF typical symptoms, to rule out FMF and its complications.
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Affiliation(s)
- Gayane Amaryan
- National Pediatrics Center for Familial Mediterranean Fever, “Arabkir” Medical Complex-Institute of Child and Adolescent Health, Yerevan, Armenia
- Department of Pediatrics, Yerevan State Medical University, Yerevan, Armenia
| | - Tamara Sarkisian
- Center of Medical Genetics and Primary Health Care, Yerevan, Armenia
- Department of Medical Genetics, Yerevan State Medical University, Yerevan, Armenia
| | - Artashes Tadevosyan
- Department of Public Health and Health Care Organization, Yerevan State Medical University, Yerevan, Armenia
| | - Christian Braegger
- Nutrition Research Unit, Children’s University Hospital in Zürich, Zürich, Switzerland
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Pisacreta AM, Mascolo R, Nivuori M, Dominioni CC, Gabiati C, Trotta L, Pancrazi M, Marco GD, Carollo C, Pedroli A, Casarin F, Tombetti E, Bizzi E, Imazio M, Brucato A. Acute pericarditis with pleuropulmonary involvement, fever and elevated C-reactive protein: A systemic autoinflammatory disease? A cohort study. Eur J Intern Med 2023; 113:45-48. [PMID: 37069014 DOI: 10.1016/j.ejim.2023.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVES This cohort study describes a systemic phenotype of pericarditis, comparing this phenotype with other forms of pericarditis. PATIENTS AND METHODS Patients in our center were enrolled in a prospectively maintained registry from 2019 to 2022. 412 patients with idiopathic recurrent pericarditis were analyzed. "Systemic inflammatory" subset was defined as the presence of all the following criteria: fever ≥38C°, CRP ≥2 times normal values, pleural effusion detected with any imaging techniques. The absence of any of the 3 criteria was defined as "isolated" subset. RESULTS We found that 211 (51.2%) of 412 patients (188 female) presented the systemic subset and the variables significantly associated with this subset in univariate analysis (p<0.001) were: higher mean age: 45.5 (±SD 17.2) vs 39.9 (±SD 16.4) years, higher mean CRP values: 128.8 vs 49.9 mg/L, higher proportion of pericardiocentesis: 19% vs 1.5%, higher mean leukocyte count: 13,143.3 vs 9910.3/mm3, higher mean neutrophils number: 10,402.5 vs 6779.8 /mm3 and lower mean lymphocyte count: 1693.9 vs 2079.3 /mm3. As results the neutrophil-to-lymphocyte ratio was higher in systemic inflammatory phenotype: 6.6 vs 3.4 (p< 0.001). Anti-IL1 therapy was started more frequently in the systemic subgroup (26%) than in the isolated subset (7.5%) (p < 0.001). On multivariate analysis neutrophil count and lymphopenia were statistically associated with the systemic subset (p < 0.001). CONCLUSION This results demonstrate the relevance of the systemic inflammatory phenotype, characterized by pleural effusions, confirming its analogy with autoinflammatory diseases, thus possibly requiring an eventual escalation of therapy to IL-1 inhibitors.
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Affiliation(s)
| | - Ruggiero Mascolo
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Mariangela Nivuori
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Claudia Gabiati
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Lucia Trotta
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Massimo Pancrazi
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Giacomo Di Marco
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Chiara Carollo
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Alice Pedroli
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Francesca Casarin
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Enrico Tombetti
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Fatebenefratelli Hospital, Università di Milano, Milan, Italy
| | - Emanuele Bizzi
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Massimo Imazio
- Cardiothoracic Department, Santa Maria della Misericordia Hospital, and DAME, University of Udine, Udine, Italy
| | - Antonio Brucato
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Fatebenefratelli Hospital, Università di Milano, Milan, Italy
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Flouda S, Moysidou GS, Damoulari C, Kapsala N, Kosmetatou M, Antoniadou A, Boumpas D, Katsimpri P. Familial Mediterranean Fever Mimicking Whipple's Disease: A Case Report and Review of the Literature. Mediterr J Rheumatol 2022; 33:252-255. [PMID: 36128209 PMCID: PMC9450193 DOI: 10.31138/mjr.33.2.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sofia Flouda
- 4th Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Biomedical Research Foundation Academy of Athens
| | - Georgia-Savvina Moysidou
- 4th Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Damoulari
- 4th Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Noemin Kapsala
- 4th Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Biomedical Research Foundation Academy of Athens
| | - Maria Kosmetatou
- 4th Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniadou
- 4th Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitros Boumpas
- 4th Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Biomedical Research Foundation Academy of Athens
| | - Pelagia Katsimpri
- 4th Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Güneş-Yılmaz S, Kasap-Demir B, Soyaltın E, Erfidan G, Özdemir-Şimşek Ö, Arslansoyu-Çamlar S, Alaygut D, Mutlubaş F. Prediction of More Severe MEFV Gene Mutations in Childhood. Turk Arch Pediatr 2022; 56:610-617. [PMID: 35110061 PMCID: PMC8849490 DOI: 10.5152/turkarchpediatr.2021.21147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aim: This study aimed to present the demographic, clinical, and laboratory features of children clinically diagnosed with familial Mediterranean fever (FMF) and to predict more severe mutations by evaluating those findings. Methods: We enrolled cases diagnosed with FMF with a defined variation in at least one allele. The medical charts of the patients were reviewed retrospectively. The patients were grouped as homozygous, compound heterozygous, and simple heterozygous cases, with and without M694V mutation. We compared the data between the subgroups using logistic regression analysis and determined the risk factors for being homozygous or compound heterozygous for M694V. Results: A total of 263 (M/F =109/154) cases were included. The mean age at the onset of symptoms, follow-up duration, and time to diagnosis were 6.75 ± 3.9 (0.25-17) years, 51.78 ± 39.31 (6-166) months, and 9.23 ± 14.44 (1-132) months, respectively. The rates of parental consanguinity, positive family history for FMF, and FMF in a first-degree relative were 15%, 42%, and 31.4% respectively. The most common symptom was abdominal pain (85%). There was no difference between the growth parameters of the cases during the initial and final control periods. The most frequent alleles were M694V, E148Q, and V726A. The most common accompanying disease was IgA vasculitis (20%). Almost 90% of the cases fulfilled all the defined criteria. The rate of patients having a first-degree relative with FMF was higher, Hb values were lower, and the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were higher during the attack period; the ESR and CRP values were higher in the attack-free period; and Pras disease severity scores were higher in homozygous or compound heterozygous cases carrying M694V. The presence of FMF in a first-degree relative increases the probability of being homozygous and compound heterozygous for M694V by a factor of 2.39; and each 1 unit increase in the Pras score increases this probability by a factor of 1.43. The threshold Pras score for this possibility is 5.5 (AUC = 0.651; 95% CI, 0.545-0.757; P = .006; sensitivity, 65%; specificity, 55%). Conclusion: M694V was the most common and severe mutation in our cohort. The presence of a first-degree relative with FMF and Pras scores ≥5.5 may predict a homozygous or compound heterozygous mutation for M694V.
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Affiliation(s)
- Seviye Güneş-Yılmaz
- Department of Pediatrics, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Belde Kasap-Demir
- Department of Pediatric Nephrology and Rheumatology, İzmir Katip Çelebi University School of Medicine, İzmir, Turkey;Department of Pediatric Nephrology, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Eren Soyaltın
- Department of Pediatric Nephrology, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Gökçen Erfidan
- Department of Pediatric Nephrology, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Özgür Özdemir-Şimşek
- Department of Pediatric Nephrology, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Seçil Arslansoyu-Çamlar
- Department of Pediatric Nephrology, University of Health Sciences School of Medicine, İzmir, Turkey
| | - Demet Alaygut
- Department of Pediatric Nephrology, University of Health Sciences School of Medicine, İzmir, Turkey
| | - Fatma Mutlubaş
- Department of Pediatric Nephrology, University of Health Sciences School of Medicine, İzmir, Turkey
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TEZCAN D, GÜLCEMAL S, LİMON M, KÖREZ MK, YİLMAZ S. Relationship Between Familial Mediterranean Fever and Other Rheumatic Diseases: Coincidence or Coexistence? TURKISH JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.46310/tjim.982632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bizzi E, Trotta L, Pancrazi M, Nivuori M, Giosia V, Matteucci L, Montori D, Brucato A. Autoimmune and Autoinflammatory Pericarditis: Definitions and New Treatments. Curr Cardiol Rep 2021; 23:128. [PMID: 34319478 DOI: 10.1007/s11886-021-01549-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE OF THE REVIEW The purpose of the review is to analyze the pathogenetic mechanisms that underlie acute pericarditis, with attention to autoimmune and autoinflammatory pericarditis, and, in addition, to review the available therapeutic armamentarium. RECENT FINDINGS Several studies have been published on the use of anti-IL-1 drugs in recurrent pericarditis, including anakinra and rilonacept. The latest, the RHAPSODY study, based on the use of rilonacept in recurrent pericarditis, has recently reached phase 3 with promising results in terms of efficacy and safety. Alterations in the function of the inflammasome and the consequent overproduction of IL-1 play a pivotal role in the genesis of autoinflammatory pericarditis. Recent studies added evidence to the importance of anti-IL-1 drugs in the treatment of recurrent pericarditis with raised C-reactive protein. In the era of tailored medicine, anti-IL-1 agents may be very useful in the subset of patients with recurrent pericarditis and a clear inflammatory phenotype.
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Affiliation(s)
- Emanuele Bizzi
- Internal Medicine, Fatebefratelli Hospital, Piazzale Principessa Clotilde 3, Milan, Italy.
| | - Lucia Trotta
- Internal Medicine, Fatebefratelli Hospital, Piazzale Principessa Clotilde 3, Milan, Italy
| | - Massimo Pancrazi
- Internal Medicine, Fatebefratelli Hospital, Piazzale Principessa Clotilde 3, Milan, Italy
| | - Mariangela Nivuori
- Internal Medicine, Fatebefratelli Hospital, Piazzale Principessa Clotilde 3, Milan, Italy
| | - Valeria Giosia
- Internal Medicine, Fatebefratelli Hospital, Piazzale Principessa Clotilde 3, Milan, Italy
| | - Luca Matteucci
- Internal Medicine, Fatebefratelli Hospital, Piazzale Principessa Clotilde 3, Milan, Italy
| | - Daniela Montori
- Internal Medicine, Fatebefratelli Hospital, Piazzale Principessa Clotilde 3, Milan, Italy
| | - Antonio Brucato
- Department of Biomedical and Clinical Sciences, Fatebenefratelli Hospital, Università di Milano, Milan, Italy
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