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Clinical and Demographic Evaluation According to MEFV Genes in Patients with Familial Mediterranean Fever

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Abstract

The present study examined the relationship between clinical findings and mutation analyses in children with Familial Mediterranean Fever (FMF) in the inner Black Sea region of Turkey. This retrospective, cross-sectional study included patients with FMF who were evaluated between 2007 and 2015. FMF was diagnosed according to the Tel Hashomer criteria. FMF mutations were analyzed using a Real-time PCR System (Roche Diagnostics, Mannheim, Germany), and patients were classified into three groups according to allele status. The most common symptom was abdominal pain (99%, n = 197). The most frequent mutations were M694V and R202Q. Chest pain was reported more often in patients homozygous for M694V (61.4%). Although fever, abdominal pain, and arthritis were more commonly observed with the M694V mutation, chest pain was the most common symptom in R202Q carriers (n = 10, 32.3%). Proteinuria was observed in 42 (21.2%) patients, frequently accompanied by the M694V mutation (28.6%). The most common mutations in children with FMF in Turkey were M694V and R202Q. Recurrent abdominal pain and arthritis/arthralgia were commonly observed in patients with M694V and R202Q mutations. Moreover, chest pain was commonly seen with the R202Q mutation. Thus, R202Q might be a disease-causing mutation in FMF patients.

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References

  • Aksentijevich I et al (1997) Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever. The International FMF Consortium. Cell 90(4):797–807

    Article  Google Scholar 

  • Arakelov G, Arakelov V, Nazaryan K (2018) Complex formation dynamics of native and mutated pyrin’s B30.2 domain with caspase-1. Proteins 86(6):676–683

    Article  CAS  PubMed  Google Scholar 

  • Bakkaloglu A (2003) Familial Mediterranean fever. Pediatr Nephrol 18(9):853–859

    Article  PubMed  Google Scholar 

  • Ben-Chetrit E, Levy M (1998) Familial Mediterranean fever. Lancet 351(9103):659–664

    Article  CAS  Google Scholar 

  • Ben-Chetrit E, Urieli-Shoval S, Calko S, Abeliovich D, Matzner Y (2002) Molecular diagnosis of FMF: lessons from a study of 446 unrelated individuals. Clin Exp Rheumatol 20(4 Suppl 26):S25–S29

    CAS  PubMed  Google Scholar 

  • Ben-Zvi I, Herskovizh C, Kukuy O, Kassel Y, Grossman C, Livneh A (2015) Familial Mediterranean fever without MEFV mutations: a case–control study. Orphanet J Rare Dis 10:34

    Article  PubMed  PubMed Central  Google Scholar 

  • Berkun Y, Eisenstein E, Ben-Chetrit E (2012) FMF—clinical features, new treatments and the role of genetic modifiers: a critical digest of the 2010–2012 literature. Clin Exp Rheumatol 30(3 Suppl 72):S90–S95

    CAS  PubMed  Google Scholar 

  • Bernot A, da Silva C, Petit JL, Cruaud C, Caloustian C, Castet V, Ahmed-Arab M, Dross C, Dupont M, Cattan D, Smaoui N, Dode C, Pecheux C, Nedelec B, Medaxian J, Rozenbaum M, Rosner I, Delpech M, Grateau G, Demaille J, Weissenbach J, Touitou I (1998) Non-founder mutations in the MEFV gene establish this gene as the cause of familial Mediterranean fever (FMF). Hum Mol Genet 7(8):1317–1325

    Article  CAS  Google Scholar 

  • Brik R, Shinawi M, Kepten I, Berant M, Gershoni-Baruch R (1999) Familial Mediterranean fever: clinical and genetic characterization in a mixed pediatric population of Jewish and Arab patients. Pediatrics 103(5):e70

    Article  CAS  PubMed  Google Scholar 

  • Caglayan AO, Demiryilmaz F, Ozyazgan I, Gumus H (2010) MEFV gene compound heterozygous mutations in familial Mediterranean fever phenotype: a retrospective clinical and molecular study. Nephrol Dial Transplant 25(8):2520–2523

    Article  CAS  PubMed  Google Scholar 

  • Coskun S, Ustyol L, Bayram Y, Selcuk Bektas M, Gulsen S, Cim A, Uluca U, Savas D (2015) The spectrum of MEFV gene mutations and genotypes in Van province, the eastern region of Turkey, and report of a novel mutation (R361T). Gene 562(1):128–131

    Article  CAS  PubMed  Google Scholar 

  • Dundar M, Kiraz A, Emirogullari EF, Saatci CE, Taheri S, Baskol M, Polat S, Ozkul Y (2012) A molecular analysis of familial Mediterranean fever disease in a cohort of Turkish patients. Ann Saudi Med 32(4):343–348

    Article  PubMed  PubMed Central  Google Scholar 

  • Dusunsel R, Dursun I, Gunduz Z, Poyrazoglu MH, Gurgoze MK, Dundar M (2008) Genotype-phenotype correlation in children with familial Mediterranean fever in a Turkish population. Pediatr Int 50(2):208–212

    Article  CAS  PubMed  Google Scholar 

  • Ece A, Cakmak E, Uluca U, Kelekci S, Yolbas I, Gunes A, Yel S, Tan I, Sen V (2014) The MEFV mutations and their clinical correlations in children with familial Mediterranean fever in southeast Turkey. Rheumatol Int 34(2):207–212

    Article  CAS  PubMed  Google Scholar 

  • Fentoglu O, Dinç G, Bagcı O, Doğru A, Ilhan I, Kırzıoglu FY, Orhan H (2017) R202Q/M694V as novel MEFV gene mutations in chronic periodontitis and familial Mediterranean fever. J Periodontal Res 52(6):994–1003

    Article  CAS  PubMed  Google Scholar 

  • Gershoni-Baruch R, Brik R, Shinawi M, Livneh A (2002) The differential contribution of MEFV mutant alleles to the clinical profile of familial Mediterranean fever. Eur J Hum Genet 10(2):145–149

    Article  CAS  PubMed  Google Scholar 

  • Giaglis S, Papadopoulos V, Kambas K, Doumas M, Tsironidou V, Rafail S, Kartalis G, Speletas M, Ritis K (2007) MEFV alterations and population genetics analysis in a large cohort of Greek patients with familial Mediterranean fever. Clin Genet 71(5):458–467

    Article  CAS  Google Scholar 

  • Gumus E (2018) The frequency of MEFV gene mutations and genotypes in Sanliurfa Province, south-eastern region of Turkey, after the Syrian Civil War by using next generation sequencing and report of a novel exon 4 mutation (I423T). J Clin Med 7(5):105

    Article  CAS  PubMed Central  Google Scholar 

  • Gunesacar R, Celik MM, Arica V, Elmacioglu S, Ozturk OH (2014) Frequency of MEFV gene mutations in Hatay province, Mediterranean region of Turkey and report of a novel missense mutation (I247V). Gene 546(2):195–199

    Article  CAS  PubMed  Google Scholar 

  • Kilic A, Varkal MA, Durmus MS, Yildiz I, Yildirim ZN, Turunc G, Oguz F, Sidal M, Omeroglu RE, Emre S, Yilmaz Y, Kelesoglu FM, Gencay GA, Temurhan S, Aydin F, Unuvar E (2015) Relationship between clinical findings and genetic mutations in patients with familial Mediterranean fever. Pediatr Rheumatol Online J 13:59

    Article  PubMed  PubMed Central  Google Scholar 

  • Kilinc M, Ganiyusufoglu E, Sager H, Celik A, Olgar S, Cetin GY, Davutoglu M, Altunoren O (2016) The report of sequence analysis on familial Mediterranean fever gene(MEFV) in South-eastern Mediterranean region (Kahramanmaras) of Turkey. Rheumatol Int 36(1):25–31

    Article  CAS  PubMed  Google Scholar 

  • Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, Migdal A, Padeh S, Pras M (1997) Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 40(10):1879–1885

    Article  CAS  Google Scholar 

  • Moradian MM, Babikyan D, Banoian D, Hayrapetyan H, Manvelyan H, Avanesian N, Sarkisian T (2017) Comprehensive analysis of mutations in the MEFV gene reveal that the location and not the substitution type determines symptom severity in FMF. Mol Genet Genomic Med 5(6):742–750

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Oksuz MF, Karakucak M, Gorukmez O, Ocakoglu G, Yıldız A, Ture M, Yakut T, Dilek K (2017) Investigations of MEFV gene polymorphisms (G138G and A165A) in adult patients with familial Mediterranean fever. Rev Bras Reumatol 57(6):501–506

    Article  Google Scholar 

  • Ozalkaya E, Mir S, Sozeri B, Berdeli A, Mutlubas F, Cura A (2011) Familial Mediterranean fever gene mutation frequencies and genotype–phenotype correlations in the Aegean region of Turkey. Rheumatol Int 31(6):779–784

    Article  PubMed  Google Scholar 

  • Ozkaya N, Elhan AH (2000) Genotype–phenotype correlation in a large group of Turkish patients with familial Mediterranean fever: evidence for mutation-independent amyloidosis. Rheumatology (Oxford) 39(1):67–72

    Article  Google Scholar 

  • Ozturk C, Halıcıoglu O, Coker I, Gulez N, Sutçuoglu S, Karaca N, Aksu G, Kutukculer N (2012) Association of clinical and genetical features in FMF with focus on MEFV strip assay sensitivity in 452 children from western Anatolia, Turkey. Clin Rheumatol 31:493–501

    Article  Google Scholar 

  • Papadopoulos V, Mitroulis I, Giaglis S (2010) MEFV heterogeneity in Turkish familial Mediterranean fever patients. Mol Biol Rep 37(1):355–358

    Article  CAS  PubMed  Google Scholar 

  • Pras E, Livneh A, Balow JE Jr, Pras E, Kastner DL, Pras M, Langevitz P (1998) Clinical differences between North African and Iraqi Jews with familial Mediterranean fever. Am J Med Genet 75(2):216–219

    Article  CAS  PubMed  Google Scholar 

  • Ritis K, Giaglis S, Spathari N, Micheli A, Zonios D, Tzoanopoulos D, Deltas CC, Rafail S, Mean R, Papadopoulos V, Tzioufas AG, Moutsopoulos HM, Kartalis G (2004) Non-isotopic RNase cleavage assay for mutation detection in MEFV, the gene responsible for familial Mediterranean fever, in a cohort of Greek patients. Ann Rheum Dis 63(4):438–443

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Samuels J, Aksentijevich I, Torosyan Y, Centola M, Deng Z, Sood R, Kastner DL (1998) Familial Mediterranean fever at the millennium. Clinical spectrum, ancient mutations, and a survey of 100 American referrals to the National Institutes of Health. Medicine (Baltimore) 77(4):268–297

    Article  CAS  Google Scholar 

  • Shohat M, Halpern GJ (2011) Familial Mediterranean fever—a review. Genet Med 13(6):487–498

    Article  Google Scholar 

  • The International FMF Consortium (1997) Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever. Cell 90(4):797–807

    Article  Google Scholar 

  • Touitou I (2001) The spectrum of familial Mediterranean fever (FMF) mutations. Eur J Hum Genet 9(7):473–483

    Article  CAS  PubMed  Google Scholar 

  • Tunca M, Akar S, Onen F, Ozdogan H, Kasapcopur O, Yalcinkaya F, Tutar E, Ozen S, Topaloglu R, Yilmaz E, Arici M, Bakkaloglu A, Besbas N, Akpolat T, Dinc A, Erken E (2005) Familial Mediterranean fever (FMF) in Turkey: results of a nationwide multicenter study. Medicine (Baltimore) 84(1):1–11

    Article  Google Scholar 

  • Ureten K, Gonulalan G, Akbal E, Gunes F, Akyurek O, Ozbek M, Ozturk MA (2010) Demographic, clinical and mutational characteristics of Turkish familial Mediterranean fever patients: results of a single center in Central Anatolia. Rheumatol Int 30(7):911–915

    Article  PubMed  Google Scholar 

  • Weinert C, Grütter C, Roschitzki-Voser H, Mittl PRE, Grütter MG (2009) The crystal structure of human pyrin B30.2 domain: implications for mutations associated with familial Mediterranean fever. J Mol Biol 394:226–236

    Article  CAS  PubMed  Google Scholar 

  • Yalcinkaya F, Cakar N, Misirlioglu M, Tumer N, Akar N, Tekin M, Tastan H, Kocak H, Ozkaya N, Elhan AH (2000) Genotype-phenotype correlation in a large group of Turkish patients with familial Mediterranean fever: evidence for mutation-independent amyloidosis. Rheumatology (Oxford) 39(1):67–72

    Article  CAS  Google Scholar 

  • Yigit S, Karakus N, Tasliyurt T, Kaya SU, Bozkurt N, Kisacik B (2012) Significance of MEFV gene R202Q polymorphism in Turkish familial Mediterranean fever patients. Gene 506(1):43–45

    Article  CAS  PubMed  Google Scholar 

  • Yilmaz E, Ozen S, Balci B, Duzova A, Topaloglu R, Besbas N, Saatci U, Bakkaloglu A, Ozguc M (2001) Mutation frequency of familial Mediterranean fever and evidence for a high carrier rate in the Turkish population. Eur J Hum Genet 9(7):553–555

    Article  CAS  PubMed  Google Scholar 

  • Yilmaz R, Ozer S, Ozyurt H, Erkorkmaz U, Sahin S (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  Google Scholar 

  • Öztürk A, Özçakar B, Ekim M, Akar N (2008) Is MEFVGene Arg202Gln (605 G%3eA) A Disease-Causing Mutation? Turk J Med Sci 38(3):205–208

    Google Scholar 

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Correspondence to Ergün Sönmezgöz.

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Sönmezgöz, E., Özer, S., Gül, A. et al. Clinical and Demographic Evaluation According to MEFV Genes in Patients with Familial Mediterranean Fever. Biochem Genet 57, 289–300 (2019). https://doi.org/10.1007/s10528-018-9889-y

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  • DOI: https://doi.org/10.1007/s10528-018-9889-y

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