Skip to main content
Log in

Bone mineral density in children with familial Mediterranean fever

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The aim of this study was to evaluate bone mineral content (BMC), serum and urinary bone turnover parameters in patients with familial Mediterranean fever (FMF), an autosomal recessive disease characterized by recurrent episodes of inflammation of serous membranes. Demographic characteristics and MEFV mutations were defined in 48 children diagnosed with FMF (23 F, 25 M; median age 7.0 years (3.0–10.0)). We evaluated the blood counts, acute-phase proteins and serum and urinary bone turnover parameters during attack-free periods. The BMC and BA (bone area) of vertebrae L1–L4 were measured by DEXA. Thirty-eight age-, sex- and ethnicity-matched healthy children constituted the control group. Mean L1–L4 BMC in Group I (patients with two mutations) and II (patients with no or single mutations) were 15.49±5.99 g and 15.68±4.89 g, respectively, both significantly lower than the mean L1–L4 BMC of control patients, which was 19.59±6.7 g (p<0.05). Mean L1–L4 BMD in Group I, Group II and the control group were 0.466±0.066 g/cm2, 0.487±0.085 g/cm2 and 0.513±0.079 g/cm2, respectively. Mean z-scores in Group I, Group II and the control group were –1.87±0.74, -1.55±0.92 and –1.39±0.84, respectively. Mean L1–L4 BMD and z-score of Group I were lower than in the control group (p<0.05). ESR and SAA (serum amyloid A) levels were higher in Group I patients: 28.3±14.5 mm/h and 350±62 mg/l in Group I; and 20.5±11.7 mm/h and 190±68 mg/l in Group II, respectively. In conclusion, FMF patients had lower BMC, BMD and z-scores than a control group. We suggest that decreased BMD, BMC and z-score in FMF patients may be secondary to subclinical inflammation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

BA:

Bone area

BMC:

Bone mineral content

BMD:

Bone mineral density

bsALP:

Bone-specific alkaline phosphatase

BMI:

Body mass index

DEXA:

Dual energy X-ray absorptiometry

DGGE:

Denaturing gradient gel electrophoresis

DPD/Cre:

Deoxypyridinoline/creatinine

FMF:

Familial Mediterranean fever

SAA:

Serum amyloid A

References

  1. Sohar E, Gafni J, Pras M, Heller H (1967) Familial Mediterranean fever: A survey of 470 cases and review of the literature. Am J Med 43:227–253

    CAS  PubMed  Google Scholar 

  2. The French Consortium (1997) A candidate gene for FMF. Nature Genet 17:25–31

    PubMed  Google Scholar 

  3. The International FMF Consortium (1997) Ancient missense mutations in a new member of the RoRet gene family are likely to cause FMF. Cell 90:797–807

    PubMed  Google Scholar 

  4. Tunca M, Kirkali G, Soytürk M, Akar S, Pepys MB, Hawkins PN (1999) Acute phase response and evolution of familial Mediterranean fever. Lancet 353:1415

    Article  CAS  Google Scholar 

  5. Duzova A, Bakkaloglu A, Besbas N et al (2003) Role of serum amyloid A (SAA) in monitoring subclinical inflammation and in colchicine dosage in familial Mediterranean fever. Clin Exp Rheumatol 21:509–514

    CAS  PubMed  Google Scholar 

  6. Zemer D, Livneh A, Danon YL, Pras M, Sohar E (1991) Long-term colchicine in children with familial Mediterranean fever. Arthritis Rheum 34:973–977

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  8. Tanner JM, Whitehouse RH, Takaishi M (1966) Standards from birth to maturity for height, weight, height velocity and weight velocity: British children 1965. Arch Dis Child 41:454–471

    CAS  PubMed  Google Scholar 

  9. Cole TJ, Freeman JV, Preece MA (1995) Body mass index reference curves for the UK. Arch Dis Child 73:25–29

    CAS  PubMed  Google Scholar 

  10. Yalcinkaya F, Cakar N, Misirlioglu M et al (2000) Genotype-phenotype correlation in a large group of Turkish patients with familial Mediterranean fever: evidence for mutation independent amyloidosis. Rheumatology 39:67–72

    PubMed  Google Scholar 

  11. Oliveri MB, Wittich A, Mautalen C, Chaperon A, Kizlanski A (2000) Peripheral bone mass is not affected by winter vitamin D deficiency in children and young adults from Ushuaia. Calcif Tissue Int 67:220–224

    Article  CAS  PubMed  Google Scholar 

  12. Kristinsson JO, Valdimarsson O, Sigurdsson G, Franzson L, Olafsson I, Steingrimsdottir L (1998) Serum 25-hydroxyvitamin D levels and bone mineral density in 16–20 year-old girls: lack of association. J Intern Med 243:381–388

    Google Scholar 

  13. Dode C, Pecheux C, Cazeneuve C et al (2000) Mutations in MEFV gene in a large series of patients with a clinical diagnosis of familial Mediterranean fever. Am J Med Genet 92:241–246

    Article  PubMed  Google Scholar 

  14. Brik R, Shinawi, Kepten I, Berant M, Gershoni-Barush R (1999) Familial Mediterranean fever: clinical and genetic characterization in a mixed pediatric population of Jewish and Arab patients. Pediatrics 103:1025–1026

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ali Duzova.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duzova, A., Ozaltin, F., Ozon, A. et al. Bone mineral density in children with familial Mediterranean fever. Clin Rheumatol 23, 230–234 (2004). https://doi.org/10.1007/s10067-004-0874-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-004-0874-y

Keywords

Navigation