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Evaluation of hematological parameters in children with FMF

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Abstract

In this study, we aimed to investigate whether neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV) might be helpful in the diagnosis of subclinical inflammation of familial Mediterranean fever (FMF). Clinical, laboratory, and genetic results of the patients who were followed up with the diagnosis of FMF were obtained retrospectively from the hospital files and recorded to standardized form. Age- and sex-matched healthy subjects were included as the control group. Eighty-three of the 143 patients (58.0%) were male and 60 (42.0%) were female. The mean age of our patients was 164.62 ± 51.20 months and the mean age of the control group was 164.92 ± 51.10 months. The mean diagnosis age of our patients was 98.10 ± 49.11 months. The mean follow-up time of the patients was 66.03 ± 36.37 months. 91.60% of our patients had abdominal pain, 78.32% fever, and 28.67% joint pain. The mean NLR of the patients was significantly higher than the mean levels at attack-free period and the control group. However, no statistically significant difference was found between the mean levels at attack-free period and the control group. MPV levels were statistically significantly high during acute attack when compared with the control group. However, they showed no statistically significant difference between acute attack and attack-free period. NLR is a useful marker to predict inflammation in FMF patients. However, our results did not support the idea that MPV might reflect acute attack and attack-free period.

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References

  1. Livneh A, Langevitz P (2000) Diagnostic and treatment concerns in familial Mediterranean fever. Baillieres Best Pract Res Clin Rheumatol 14:477–498

    Article  PubMed  CAS  Google Scholar 

  2. Savic S, Dickie LJ, Wittmann M, McDermott MF (2012) Autoinflammatory syndromes and cellular responses to stress: pathophysiology, diagnosis and new treatment perspectives. Best Pract Res Clin Rheumatol 26(4):505–533

    Article  PubMed  CAS  Google Scholar 

  3. Yilmaz R, Ozer S, Ozyurt H et al (2009) Familial Mediterranean fever gene mutations in the inner northern region of Turkey and genotype-phenotype correlation in children. J Paediatr Child Health 45(11):641–645

    Article  PubMed  Google Scholar 

  4. Samuels J, Aksentijevich I, Torosyan Y et al (1998) Familial Mediterranean fever at the millenium. Clinical spectrum, ancient mutations and a survey of 100 American referrals to the National Institutes of Health. Medicine (Baltimore) 77:268–297

    Article  CAS  Google Scholar 

  5. Turkish FMF Study Group (2005) Familial Mediterranean fever (FMF) in Turkey results of a nationwide multicenter study. Medicine 84:1–11

    Article  Google Scholar 

  6. Uslu AU, Deveci K, Korkmaz SE et al (2013) Is neutrophil/lymphocyte ratio associated with subclinical inflammation and amyloidosis in patients with familial Mediterranean fever? Biomed Res Int 2013:185317

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ahsen A, Ulu MS, Yuksel S et al (2013) As a new inflammatory marker for familial Mediterranean fever: neutrophil-to-lymphocyte ratio. Inflammation 36(6):1357–1362

    Article  PubMed  CAS  Google Scholar 

  8. Bilginer Y, Akpolat T, Ozen S (2011) Renal amyloidosis in children. Pediatr Nephrol 26:1215–1227

    Article  PubMed  PubMed Central  Google Scholar 

  9. Uluca Ü, Demir F, Ece A, Sen V, Günes A, Aktar F et al (2015) Assessment of epicardial adipose tissue thickness and the mean platelet volume in children with familial Mediterranean fever. Ital J Pediatr 41:15

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sakalli H, Kal O (2013) Mean platelet volume as a potential predictor of proteinuria and amyloidosis in familial Mediterranean fever. Clin Rheumatol 32(8):1185–1190

    Article  PubMed  Google Scholar 

  11. Akbas EM, Demirtas L, Ozcicek A, Timuroglu A, Bakirci EM, Hamur H, Ozcicek F, Turkmen K (2014) Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy. Int J Clin Exp Med 7(7):1794–1801

    PubMed  PubMed Central  Google Scholar 

  12. Taşoğlu İ, Sert D, Colak N et al (2013) Neutrophil-lymphocyte ratio and the platelet–lymphocyte ratio predict the limb survival in critical limb ischemia. Clin Appl Thromb Hemost 20(6):645–650

    Article  PubMed  Google Scholar 

  13. Livneh A, Langevitz P, Zemer D et al (1997) Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 40(10):1879–1885

    Article  PubMed  CAS  Google Scholar 

  14. Kim ML, Chae JJ, Park YH, de Nardo D, Stirzaker RA, Ko HJ, Tye H, Cengia L, DiRago L, Metcalf D, Roberts AW, Kastner DL, Lew AM, Lyras D, Kile BT, Croker BA, Masters SL (2015) Aberrant actin depolymerization triggers the pyrin inflammasome and autoinflammatory disease that is dependent on IL-18, not IL-1beta. J Exp Med 212:927–938

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hoffman HM (2009) Therapy of autoinflammatory syndromes. J Allergy Clin Immunol 124:1129–1138

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Ben-Zvi I, Livneh A (2011) Chronic inflammation in FMF: markers, risk factors, outcomes and therapy. Nat Rev Rheumatol 7:105–112

    Article  PubMed  CAS  Google Scholar 

  17. Manukyan GP, Ghazaryan KA, Ktsoyan Zh A et al (2008) Cytokine profile of Armenian patients with familial Mediterranean fever. Clin Biochem 41:920–922

    Article  PubMed  CAS  Google Scholar 

  18. Yildrim K, Uzkeser H, Keles M et al (2012) Relationship between serum interleukin-1β levels and acute phase response proteins in patients with familial Mediterranean fever. Biochem Med 22:109–113

    Article  Google Scholar 

  19. Oktem S, Yavuzsen TU, Sengul B et al (2004) Levels of interleukin-6 and its soluble receptor in familial Mediterranean fever (FMF) patients and their first degree relatives. Clin Exp Rheumatol 22:34–36

    Google Scholar 

  20. Baykal Y, Saglam K, Yilmaz MI, Taslipinar A, Akinci SB, Inal A (2003) Serum sIL-2r, IL-6, IL-10 and TNF-alpha level in familial Mediterranean fever patients. Clin Rheumatol 22:99–101

    Article  PubMed  CAS  Google Scholar 

  21. Gang N, Drenth JP, Langevitz P, Zemer D, Brezniak N, Pras M, van der Meer J, Livneh A (1999) Activation of the cytokine network in familial Mediterranean fever. J Rheumatol 26:890–897

    PubMed  CAS  Google Scholar 

  22. Marnell L, Mold C, Du Clos TW (2005) C-reactive protein: ligands, receptors and role in inflammation. Clin Immunol 117:104–111

    Article  PubMed  CAS  Google Scholar 

  23. Zahorec R (2001) Ratio of neutrophil to lymphocyte counts – rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 102:5–14

    PubMed  CAS  Google Scholar 

  24. Özer S, Yilmaz R, Sönmezgöz E, Karaaslan E, Taskin S, Bütün I et al (2015) Simple markers for subclinical inflammation in patients with familial Mediterranean fever. Med Sci Monit 21:298–303

    Article  PubMed  PubMed Central  Google Scholar 

  25. Celikbilek M, Dogan S, Akyol L et al (2015) Neutrophil-lymphocyte ratio in patients with familial Mediterranean fever. J Clin Lab Anal 29:80–83

    Article  PubMed  CAS  Google Scholar 

  26. Park Y, Schoene N, Harris W (2002) Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 13:301–306

    Article  PubMed  CAS  Google Scholar 

  27. Makay B, Gücenmez ÖA, Duman M, Ünsal E (2014) The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Rheumatol Int 34:1323–1327

    Article  PubMed  CAS  Google Scholar 

  28. Yuksel S, Ayvazyan L, Gasparyan AY (2010) Familial Mediterranean fever as an emerging clinical model of atherogenesis associated with low-grade inflammation. Open Cardiovasc Med J 4:51–56

    PubMed  PubMed Central  CAS  Google Scholar 

  29. Makay B, Turkyilmaz Z, Unsal E (2009) Mean platelet volume in children with familial Mediterranean fever. Clin Rheumatol 28:975–978

    Article  PubMed  Google Scholar 

  30. Arıca S, Ozer C, Arıca V, Karakuş A, Celik T, Güneşaçar R (2012) Evaluation of the mean platelet volume in children with familial Mediterranean fever. Rheumatol Int 32:3559–3563

    Article  PubMed  Google Scholar 

  31. Coban E, Adanir H (2008) Platelet activation in patients with familial Mediterranean fever. Platelets 19:405–408

    Article  PubMed  CAS  Google Scholar 

  32. Uluca Ü, Ece A, Sen V, Karabel D, Yel S, Günes A et al (2014) Usefulness of mean platelet volume and neutrophil-to-lymphocyte ratio for evaluation of children with familial Mediterranean fever. Med Sci Monit 20:1578–1582

    Article  PubMed  PubMed Central  Google Scholar 

  33. Cavusoglu E, Chopra V, Gupta A, Battala VR, Poludasu S, Eng C, Marmur JD (2010) Relation between red blood cell distribution width and all-cause mortality at two years in an unselected population referred for coronary angiography. Int J Cardiol 141:141–146

    Article  PubMed  Google Scholar 

  34. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC (2009) Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 133:628–632

    PubMed  CAS  Google Scholar 

  35. Yildirim Cetin G, Gul O, Kesici-Metin F, Gokalp I, Sayarlıoglu M (2014) Evaluation of the mean platelet volume and red cell distribution width in FMF: are they related to subclinical inflammation or not? Int J Chronic Dis:1–5

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Authors and Affiliations

  1. Department of Pediatrics, Selçuk University Medical School, Konya, Turkey

    Alaaddin Yorulmaz, Hikmet Akbulut, Suna Adeviye Taş, Merve Tıraş & İbaa Yahya

  2. Department of Pediatric Rheumatology, Selçuk University Medical School, Konya, Turkey

    Harun Peru

Authors
  1. Alaaddin Yorulmaz
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  2. Hikmet Akbulut
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  3. Suna Adeviye Taş
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  4. Merve Tıraş
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  5. İbaa Yahya
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  6. Harun Peru
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Correspondence to Alaaddin Yorulmaz.

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All patients provided written informed consent. The study was approved by the local ethics committee.

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Yorulmaz, A., Akbulut, H., Taş, S.A. et al. Evaluation of hematological parameters in children with FMF. Clin Rheumatol 38, 701–707 (2019). https://doi.org/10.1007/s10067-018-4338-1

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  • DOI: https://doi.org/10.1007/s10067-018-4338-1

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