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Fatigue in familial Mediterranean fever and its relations with other clinical parameters

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Abstract

Fatigue is a common problem in patients with rheumatic disease. It may cause disability and poor quality of life. The aim of this study is to investigate fatigue in FMF patients as a disabling symptom and its associations with clinical and demographic variables. FMF patients were recruited into the study according to FMF Tel Hashomer criteria. Control group is composed of healthy individuals. Demographic and clinical features of the patients including PRAS scores were noted. Visual analogue score of pain (VAS-pain) and VAS-fatigue were used as clinical parameters. Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF), Nottingham Health Profile (NHP), Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS) and Hospital Anxiety and Depression Scale (HADS) were filled out by both control and study group. Sixty-one FMF patients and 61 age and gender (44 female, 17 male in each group)-matched controls were enrolled into the study. Mean age of FMF and control group were 35.5 ± 11.8 and 35.8 ± 11.7 years, respectively. The mean disease duration was 82.5 ± 81.7 months. Difference between mean of VAS-pain, VAS-fatigue, PSQI total score, MAF, all subsets of NHP, FSS, FIS, and HADS scores of FMF patients was significantly higher than of control group (p = 0.0001). This study has shown that fatigue in FMF is associated with a number of psychological, sleep, quality of life and disease-related factors. FMF group had increased pain, fatigue, sleep disturbance and decreased quality of life compared to control group. FMF patients with fatigue may benefit from pharmacological and psychological interventions which target these factors.

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References

  1. Firestein GS, Budd R, Gabriel SE, McInnes IB, O’Dell JR (2012) Kelley’s textbook of rheumatology. Elsevier Health Sciences, Philadelphia

    Google Scholar 

  2. Heller H, Sohar E, Sherf L (1958) Familial mediterranean fever. AMA Arch Intern Med 102(1):50–71

    Article  CAS  PubMed  Google Scholar 

  3. Goldfinger SE (1972) Colchicine for familial Mediterranean fever. N Engl J Med 287(25):1302. https://doi.org/10.1056/nejm197212212872514

    CAS  PubMed  Google Scholar 

  4. Stebbings S, Treharne GJ (2010) Fatigue in rheumatic disease: an overview. Int J Clin Rheumatol 5(4):487–502

    Article  Google Scholar 

  5. Jump RL, Robinson ME, Armstrong AE, Barnes EV, Kilbourn KM, Richards HB (2005) Fatigue in systemic lupus erythematosus: contributions of disease activity, pain, depression, and perceived social support. J Rheumatol 32(9):1699–1705

    PubMed  Google Scholar 

  6. Pollard L, Choy E, Gonzalez J, Khoshaba B, Scott D (2006) Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatology 45(7):885–889

    Article  CAS  PubMed  Google Scholar 

  7. Turan Y, Duruöz MT, Bal S, Guvenc A, Cerrahoglu L, Gurgan A (2007) Assessment of fatigue in patients with ankylosing spondylitis. Rheumatol Int 27(9):847–852

    Article  PubMed  Google Scholar 

  8. Huyser BA, Parker JC, Thoreson R, Smarr KL, Johnson JC, Hoffman R (1998) Predictors of subjective fatigue among individuals with rheumatoid arthritis. Arthritis Rheumatol 41(12):2230–2237

    Article  CAS  Google Scholar 

  9. Wolfe F, Michaud K, Li T (2006) Sleep disturbance in patients with rheumatoid arthritis: evaluation by medical outcomes study and visual analog sleep scales. J Rheumatol 33(10):1942–1951

    PubMed  Google Scholar 

  10. 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 Rheumatism 40(10):1879–1885. https://doi.org/10.1002/art.1780401023

    Article  CAS  PubMed  Google Scholar 

  11. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RL, Mease PJ, Russell AS, Russell IJ, Walitt B (2016) 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 46(3):319–329. https://doi.org/10.1016/j.semarthrit.2016.08.012

    Article  PubMed  Google Scholar 

  12. 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 

  13. McCormack HM, Horne DJ, Sheather S (1988) Clinical applications of visual analogue scales: a critical review. Psychol Med 18(4):1007–1019

    Article  CAS  PubMed  Google Scholar 

  14. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    Article  CAS  PubMed  Google Scholar 

  15. Belza Bl H, Cj Y, Eh E, Wv GC (1993) Correlates of fatigue in older adults with rheumatoid arthritis. Nurs Res 42(2):93–99

    Article  PubMed  Google Scholar 

  16. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121–1123

    Article  CAS  PubMed  Google Scholar 

  17. Fisk JD, Ritvo PG, Ross L, Haase DA, Marrie TJ, Schlech WF (1994) Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis 18(Supplement 1):S79–S83

    Google Scholar 

  18. Hunt SM, McKenna SP, McEwen J, Williams J, Papp E (1981) The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A 15(3 Pt 1):221–229

    CAS  PubMed  Google Scholar 

  19. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  PubMed  Google Scholar 

  20. Ulus Y, Akyol Y, Tander B, Durmus D, Bilgici A, Kuru O (2011) Sleep quality in fibromyalgia and rheumatoid arthritis: associations with pain, fatigue, depression, and disease activity. Clin Exp Rheumatol Incl Suppl 29(6):S92

    CAS  Google Scholar 

  21. Katz P, Margaretten M, Trupin L, Schmajuk G, Yazdany J, Yelin E (2016) Role of sleep disturbance, depression, obesity, and physical inactivity in fatigue in rheumatoid arthritis. Arthritis Care Res 68(1):81–90

    Article  Google Scholar 

  22. Morris G, Berk M, Galecki P, Walder K, Maes M (2016) The neuro-immune pathophysiology of central and peripheral fatigue in systemic immune-inflammatory and neuro-immune diseases. Mol Neurobiol 53(2):1195–1219

    Article  CAS  PubMed  Google Scholar 

  23. Wolfe F, Hawley DJ, Wilson K (1996) The prevalence and meaning of fatigue in rheumatic disease. J Rheumatol 23(8):1407–1417

    CAS  PubMed  Google Scholar 

  24. Nicassio PM (2016) Psychosocial factors in arthritis. Springer, Berlin

    Book  Google Scholar 

  25. Konukbay D, Yildiz D, Acikel C, Karaman D, Fidanci BE, Bilginer Y, Polat A, Kone-Paut I, Frenkel J, Gattorno M (2014) Evaluation of biopsychosocial aspects of patients with juvenile autoinflammatory disease: a qualitative study. Ann Paediatr Rheum 3(2):62–71

    Article  Google Scholar 

  26. Buskila D, Zaks N, Neumann L, Livneh A, Greenberg S, Pras M, Langevitz P (1997) Quality of life of patients with familial Mediterranean fever. Clin Exp Rheumatol 15(4):355–360

    CAS  PubMed  Google Scholar 

  27. Deger SM, Ozturk MA, Demirag MD, Aslan S, Goker B, Haznedaroglu S, Onat AM (2011) Health-related quality of life and its associations with mood condition in familial Mediterranean fever patients. Rheumatol Int 31(5):623–628

    Article  PubMed  Google Scholar 

  28. Sahin S, Yalcin I, Senel S, Ataseven H, Uslu A, Yildirim O, Semiz M (2013) Assessment life quality of familial Mediterranean fever patients by short form-36 and its relationship with disease parameters. Eur Rev Med Pharmacol Sci 17:958–963

    CAS  PubMed  Google Scholar 

  29. Giese A, Kurucay M, Kilic L, Örnek A, Şendur SN, Lainka E, Henning BF (2013) Quality of life in adult patients with familial Mediterranean fever living in Germany or Turkey compared to healthy subjects: a study evaluating the effect of disease severity and country of residence. Rheumatol Int 33(7):1713–1719

    Article  PubMed  Google Scholar 

  30. Giese A, Ornek A, Kilic L, Kurucay M, Sendur SN, Lainka E, Henning BF (2014) Anxiety and depression in adult patients with familial Mediterranean fever: a study comparing patients living in Germany and Turkey. Int J Rheum Dis. https://doi.org/10.1111/1756-185x.12297

    PubMed  Google Scholar 

  31. Makay B, Emiroğlu N, Ünsal E (2010) Depression and anxiety in children and adolescents with familial Mediterranean fever. Clin Rheumatol 29(4):375–379

    Article  PubMed  Google Scholar 

  32. Kucuk A, Albayrak I, Bagcaci S, Karpuz S, Kucuksen S, Tunc R (2015) Evaluation of the sleep quality in patients with familial Mediterranean fever. Acta Med Mediterr 31(2):317–321

    Google Scholar 

  33. Özcakar ZB, Yalçinkaya F, Yüksel S, Acar B, Ekim M, Gökmen D (2006) Possible effect of subclinical inflammation on daily life in familial Mediterranean fever. Clin Rheumatol 25(2):149–152

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Rheumatology Division, PMR Department, Marmara University, School of Medicine, Istanbul, Turkey

    Mehmet Tuncay Duruoz

  2. PMR Department, Marmara University, School of Medicine, Istanbul, Turkey

    Cagri Unal, Duygu Karali Bingul & Firat Ulutatar

Authors
  1. Mehmet Tuncay Duruoz
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  2. Cagri Unal
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  3. Duygu Karali Bingul
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  4. Firat Ulutatar
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Correspondence to Cagri Unal.

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The authors declare that there are no conflicts of interest.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical approval

All procedures performed in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was taken from Clinical Researches Ethical Committee of Marmara University School of Medicine. The protocol number was 09.2016.016.

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Informed consent was obtained from all individual participants included in the study.

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Duruoz, M.T., Unal, C., Bingul, D.K. et al. Fatigue in familial Mediterranean fever and its relations with other clinical parameters. Rheumatol Int 38, 75–81 (2018). https://doi.org/10.1007/s00296-017-3882-3

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  • DOI: https://doi.org/10.1007/s00296-017-3882-3

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