Acute phase reactants in the follow-up of patients with FMF

Introduction

Familial Mediterranean Fever (FMF) is the most common periodic fever syndrome. FMF characterized by recurrent fever, serositis attacks and chronic subclinical inflammation in attack-free periods.

Objective

The aim of this study was to evaluate the relevance of acute phase reactants (APR) in FMF and to determine their correlation with each other during attacks and attack-free periods.

Methods

Twenty-three children diagnosed as FMF according to the previously published criteria and followed-up at the Pediatric Rheumatology Clinic of Hacettepe Children's Hospital were enrolled in the study. The erythrocyte sedimentation rate (ESR), C reactive protein (CRP), white blood cell (WBC) count, platelet count, and serum amyloid a (SAA) were tested in the patients during an attack and in-between attacks.

Results

There were 9 male and 14 female patients. Tests were performed in 11 patients with an attack and in 12 without attacks. All patient had homozygous or compound heterozygous FMF-associated mutations. ESR, CRP, WBC, SAA were statistically significantly higher in patients with an attack (respectively p < 0,001, p <0,001, p=0.03, p=0,003). Highly significant and perfect correlation was found between SAA and CRP in patients with attack (r= 0,939, p<0,001).

There was a significant correlation between the number of attacks in the last 6 months and SAA in the patient with attack-free periods (r=0,746, p=0,005). There was no other significant correlation.

Conclusion

CRP and SAA levels correlated with each other during the FMF attacks. SAA is important to identify subclinical inflammation in FMF patients when other APRs were normal.