Abstract
This study aims to compare the mean platelet volume (MPV) levels in children and adults diagnosed with familial Mediterranean fever (FMF) during attack-free periods in order to find out whether it reflects the emergence of microalbuminuria/proteinuria and the development of amyloidosis or not. The study consisted of 63 pediatric patients (group 1), 50 adult patients (group 2), 50 healthy children (group 3), and 43 healthy adults (group 4). Demographic data, age at diagnosis, duration of the disease and colchicine treatment, and FMF gene mutations were recorded, and erythrocyte sedimentation rate, C-reactive protein, fibrinogen, hemoglobin, white blood cell count, platelet count, MPV, blood urea nitrogen, creatine, albumin, and urine microalbumin and protein levels were evaluated. According to the presence of microalbuminuria/proteinuria, patient groups were subgrouped into two by themselves as pediatric and adult groups with and without proteinuria. The most frequent mutation was M694V. MPV was significantly higher in FMF patients than those in the healthy control groups. Microalbuminuria/proteinuria were detected in 18 (28.57 %) of 63 pediatric patients and 26 (52 %) of 50 adult patients. Amyloidosis has been identified in 3 (16.6 %) of 18 pediatric patients and 18 (69.23 %) of 26 adult patients with proteinuria. Subgroup comparisons revealed that MPV levels were significantly higher in patients with proteinuria than patients without proteinuria in both pediatric and adult groups. Moreover, MPV levels were also significantly higher in adult patients with or without proteinuria than in pediatric patients with or without proteinuria. There were significant differences in terms of serum albumin levels between the groups with and without proteinuria as expected. The increase in MPV over the years of the disease, especially in groups with proteinuria, may be an important predictor of continuing increase of subclinical inflammation, the emergence of the microalbuminuria/proteinuria, and the developing of amyloidosis, but further studies are needed in order to support this proposal.
Similar content being viewed by others
References
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(2):227–253
Rogers DB, Shohat M, Petersen GM, Bickal J, Congleton J, Schwabe AD, Rotter JI (1989) Familial Mediterranean fever in Armenians: autosomal recessive inheritance with high gene frequency. Am J Med Genet 34(2):168–172
Schwabe AD, Peters RS (1974) Familial Mediterranean fever in Armenians. Analysis of 100 cases. Medicine (Baltimore) 53(6):453–462
Tauber T, Zimand S, Kotzer E. (1995) Recurrent pericarditis in familial Mediterranean fever. Harefuah 128(10):611–2, 672.
Mimouni A, Magal N, Stoffman N, Shohat T, Minasian A, Krasnov M, Halpern GJ, Rotter JI, Fischel-Ghodsian N, Danon YL, Shohat M (2000) Familial Mediterranean fever: effects of genotype and ethnicity on inflammatory attacks and amyloidosis. Pediatrics 105(5):E70
Bunker D, Gorevic P (2012) AA amyloidosis: Mount Sinai experience, 1997–2012. Mt Sinai J Med 79(6):749–756
Obici L, Merlini G (2012) AA amyloidosis: basic knowledge, unmet needs and future treatments. Swiss Med Wkly 142:w13580
Pras M, Bronshpigel N, Zemer D, Gafni J (1982) Variable incidence of amyloidosis in familial Mediterranean fever among different ethnic groups. Johns Hopkins Med J 150(1):22–26
Arıca S, Ozer C, Arıca V, Karakuş A, Celik T, Güneşaçar R (2011) Evaluation of the mean platelet volume in children with familial Mediterranean fever. Rheumatol Int 32(11):3559–3563. doi:10.1007/s00296-011-2251-x
van der Hilst JC (2011) Recent insights into the pathogenesis of type AA amyloidosis. Scientific World Journal 7(11):641–650
Sato H, Kuroda T, Tanabe N, Ajiro J, Wada Y, Murakami S, Sakatsume M, Nakano M, Gejyo F (2010) Cystatin C is a sensitive marker for detecting a reduced glomerular filtration rate when assessing chronic kidney disease in patients with rheumatoid arthritis and secondary amyloidosis. Scand J Rheumatol 39(1):33–37
Tishko AN, Lapin SV, Vavilova TV, Totolian AA (2011) Early diagnostics of kidney damage in longstanding rheumatoid arthritis and amyloidosis. Amyloid 18(1):217–218
Turkcapar N, Tuncali T, Kutlay S, Burhan BY, Kinikli G, Erturk S, Duman M (2007) The contribution of genotypes at the MICA gene triplet repeat polymorphisms and MEFV mutations to amyloidosis and course of the disease in the patients with familial Mediterranean fever. Rheumatol Int 27(6):545–551
Ergüven M, Emeksiz C, Deveci M, Ozlü SG (2008) Relation between microalbuminuria and gene mutations in familial Mediterranean fever. Turk J Pediatr 50(4):326–330
Albayrak F, Selcuk NY, Odabas AR, Cetinkaya R, Pirim I (2010) Genotype–phenotype correlation in patients with familial Mediterranean fever in East Anatolia (Turkey). Genet Test Mol Biomarkers 14(3):325–328
Korkmaz C, Ozdogan H, Kasapçopur O, Yazici H (2002) Acute phase response in familial Mediterranean fever. Ann Rheum Dis 61(1):79–81
Ulasli SS, Ozyurek BA, Yilmaz EB, Ulubay G (2012) Mean platelet volume as an inflammatory marker in acute exacerbation of chronic obstructive pulmonary disease. Pol Arch Med Wewn 122(6):284–290
Kapsoritakis AN, Koukourakis MI, Sfiridaki A, Potamianos SP, Kosmadaki MG, Koutroubakis IE, Kouroumalis EA (2001) Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol 96(3):776–781
Milovanovic M, Nilsson E, Järemo P (2004) Relationships between platelets and inflammatory markers in rheumatoid arthritis. Clin Chim Acta 343(1–2):237–240
Yazici S, Yazici M, Erer B, Erer B, Calik Y, Ozhan H, Ataoglu S (2010) The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets 21(2):122–125
Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, Kiraz S, Ertenli I, Calguneri M (2008) Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 75(3):291–294
Coban E, Adanir H (2008) Platelet activation in patients with familial Mediterranean fever. Platelets 19(6):405–408
Makay B, Türkyilmaz Z, Unsal E (2009) Mean platelet volume in children with familial Mediterranean fever. Clin Rheumatol 28(8):975–978
Sahin S, Senel S, Ataseven H, Yalcin I (2012) Does mean platelet volume influence the attack or attack-free period in the patients with familial Mediterranean fever? Platelets 122(6):284–90
Kabata J, Raszeja-Specht A, Steffek I, Angielski S (1995) Reference values for peripheral blood morphology in countryside population of northern Poland. Pol Tyg Lek 50(36–39):62–65
Shiga S, Koyanagi I, Ohsaga J, Ichiyama S, Kannagi R (1999) Clinical reference values for laboratory hematology tests calculated using the iterative truncation method with correction: part 2, reference values for white blood cell (WBC) count, WBC differential including segmented neutrophil, band neutrophil, lymphocyte, monocyte, eosinophil, basophil, platelet count and mean platelet volume. Rinsho Byori 47(3):281–288
Daniels M, Shohat T, Brenner-Ullman A, Shohat M (1995) Familial Mediterranean fever: high gene frequency among the non-Ashkenazic and Ashkenazic Jewish populations in Israel. Am J Med Genet 55(3):311–314
Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD (2011) Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 17(1):47–58
Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD (2010) Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-α therapy. Rheumatol Int 30(8):1125–1129
Zubcevic N, Mesihovic R, Zubcevic S (2010) Usefulness of laboratory data in estimation of Crohn’s disease activity. Med Arh 64(1):33–36
Yalçinkaya F, Cakar N, Acar B, Tutar E, Güriz H, Elhan AH, Oztürk S, Kansu A, Ince E, Atalay S, Girgin N, Doğru U, Aysev D, Ekim M (2007) The value of the levels of acute phase reactants for the prediction of familial Mediterranean fever associated amyloidosis: a case control study. Rheumatol Int 27(6):517–522
Duzova A, Bakkaloglu A, Besbas N, Topaloglu R, Ozen S, Ozaltin F, Bassoy Y, Yilmaz E (2003) Role of A-SAA in monitoring subclinical inflammation and in colchicine dosage in familial Mediterranean fever. Clin Exp Rheumatol 21(4):509–514
Musabak U, Sengul A, Oktenli C, Pay S, Yesilova Z, Kenar L, Sanisoglu SY, Inal A, Tuzun A, Erdil A, Bagci S (2004) Does immune activation continue during an attack-free period in familial Mediterranean fever? Clin Exp Immunol 138(3):526–533
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
Disclosures
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sakallı, H., Kal, Ö. Mean platelet volume as a potential predictor of proteinuria and amyloidosis in familial Mediterranean fever. Clin Rheumatol 32, 1185–1190 (2013). https://doi.org/10.1007/s10067-013-2257-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-013-2257-8