Doppler ultrasonography of splanchnic vessels in patients with familial Mediterranean fever

Year 2013, Volume: 2 Issue: 4, 147 - 153, 09.03.2014

İsmail Salk Emrullah Hayta Ferhat Sezer Ali Cetin Mehmet Atalar

Abstract

Abstract

Aim. In FMF patients, abdominal pain attacks commonly occur and affect the whole abdomen with all findings of peritoneal inflammation. The aim of the present study was to evaluate the selected arterial and venous ultrasonographic and Doppler ultrasonographic parameters including the peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) of superior mesenteric and celiac arteries, and blood flow velocity of portal vein in FMF patients in remission. Methods. Ultrasonographic and Doppler ultrasonographic examinations performed at our Radiology Service from January 2012 to February 2013 were reviewed retrospectively in 52 adult FMF patients in stable phase. Correlation analyses were performed to assess the association of clinical and Doppler ultrasonographic data. Results. Overall, there was no meaningful association between clinical and Doppler ultrasonographic parameters obtained from the superior mesenteric and celiac arteries and portal vein. Conclusions. In this study, we attempted to reveal the long-term effect of abdominal attacks on abdominal vessels that might be affected by experienced abdominal attacks related to long-term nature of FMF. According to our findings, FMF may not cause deterioration in blood flow of the superior mesenteric and celiac arteries and portal vein. These findings cannot be accepted as the evidence of absence of atherosclerotic changes developing in patients with long-term inflammatory disorders like FMF. Further studies are needed to shed light on the long-term effects of inflammation related to FMF on vascular system.

Keywords: Familial Mediterranean fever, Doppler ultrasonography, superior mesenteric artery, celiac artery, portal vein

Özet

Amaç. FMF olgularında karın ağrısı atakları sıklıkla görülür ve peritoneal inflamasyon bulguları ile tüm karın etkilenir. Bu çalışmanın amacı remisyondaki FMF olgularında superior mezenterik ve çöliak arterler ile portal venin pik sistolik, end diastolik, pulsatilite, ve rezistif indekslerinin Doppler ultrasonografi ile değerlendirilmesidir. Yöntem. Radyoloji servisimizde Ocak 2012-Şubat 2013 tarihleri arasında stabil fazda 52 FMF olgusunda yapılan Doppler ultrasonografi incelemelerin raporları retrospektif olarak incelendi. Klinik ve Doppler ultrasonografik veriler arasındaki ilişki korelasyon analizi ile değerlendirildi. Bulgular. Genel olarak superior mezenterik ve çöliak arterler ile portal ven Doppler ultrasonografi bulguları ile klinik bulgular arasında anlamlı ilişki saptanmadı. Sonuçlar. Bu çalışmada FMF olgularında uzun dönemde abdominal atakların abdominal damarlar üzerine etkisini değerlendirdik. Bizim bulgularımıza göre FMF superior mezenterik ve çöliak arterler ile portal vende kan akımında bozulmaya sebep olmayabilir. Bu bulgular uzun süren benzer inflamatuvar bozuklukları bulunan hastalarda aterosklerotik değişikliklerin yokluğunu göstermeyebilir. FMF olgularında damarlarda gelişen uzun dönem inflamatuvar etkinin aydınlatılması için daha fazla çalışmaya gereksinim vardır.

Anahtar sözcükler: Ailesel Akdeniz ateşi, Doppler ultrasonografi, superior mezenterik arter, çöliak arter, portal ven

Keywords

Familial Mediterranean fever, Doppler ultrasonography, superior mesenteric artery, celiac artery, portal vein

References

• Soriano A, Manna R. Familial Mediterranean fever: new phenotypes. Autoimmun Rev. 2012 Nov;12(1):31-7.
• Ben-Chetrit E, Levy M. Familial Mediterranean fever. Lancet. 1998 Feb 28;351(9103):659-64. Review. No abstract available.
• Konstantopoulos K, Kanta A, Deltas C, Atamian V, Mavrogianni D, Tzioufas AG, Kollainis I, Ritis K, Moutsopoulos HM. Familial Mediterranean fever associated pyrin mutations in Greece. Ann Rheum Dis. 2003 May;62(5):479-81.
• La Regina M, Nucera G, Diaco M, Procopio A, Gasbarrini G, Notarnicola C, Kone-Paut I, Touitou I, Manna R. Familial Mediterranean fever is no longer a rare disease in Italy. Eur J Hum Genet. 2003 Jan;11(1):50-6.
• Telatar M, Grody WW. Molecular genetic testing for familial Mediterranean fever. Mol Genet Metab. 2000 Sep-Oct;71(1-2):256-60.
• Korkmaz C, Ozdogan H, Kasapçopur O, Yazici H. Acute phase response in familial Mediterranean fever. Ann Rheum Dis. 2002 Jan;61(1):79-81.
• Lachmann HJ, Sengül B, Yavuzşen TU, Booth DR, Booth SE, Bybee A, Gallimore JR, Soytürk M, Akar S, Tunca M, Hawkins PN. Clinical and subclinical inflammation in patients with familial Mediterranean fever and in heterozygous carriers of MEFV mutations. Rheumatology (Oxford). 2006 Jun;45(6):746-50.
• Haznedaroglu S, Oztürk MA, Sancak B, Goker B, Onat AM, Bukan N, Ertenli I, Kiraz S, Calguneri M. Serum interleukin 17 and interleukin 18 levels in familial Mediterranean fever. Clin Exp Rheumatol. 2005 Jul-Aug;23(4 Suppl 38):S77-80.
• Tunca M, Kirkali G, Soytürk M, Akar S, Pepys MB, Hawkins PN. Acute phase response and evolution of familial Mediterranean fever. Lancet. 1999 Apr 24;353(9162):1415.
• Knecht A, de Beer FC, Pras M. Serum amyloid A protein in familial Mediterranean fever. Ann Intern Med. 1985 Jan;102(1):71-2.
• Gang N, Drenth JP, Langevitz P et al (1999) Activation of the cytokine network in familial Mediterranean fever. J Rheumatol 26 (4):890–897
• Peru H, Altun B, Doğan M, Kara F, Elmaci AM, Oran B. The evaluation of carotid intima-media thickness in children with familial Mediterranean fever. Clin Rheumatol. 2008 Jun;27(6):689-94.
• Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation. 2003 Jan 28;107(3):391-7.
• Yang RZ, Lee MJ, Hu H, Pollin TI, Ryan AS, Nicklas BJ, Snitker S, Horenstein RB, Hull K, Goldberg NH, Goldberg AP, Shuldiner AR, Fried SK, Gong DW. Acute-phase serum amyloid A: an inflammatory adipokine and potential link between obesity and its metabolic complications. PLoS Med. 2006 Jun;3(6):e287.
• Schillinger M, Exner M, Mlekusch W, Sabeti S, Amighi J, Nikowitsch R, Timmel E, Kickinger B, Minar C, Pones M, Lalouschek W, Rumpold H, Maurer G, Wagner O, Minar E. Inflammation and Carotid Artery--Risk for Atherosclerosis Study (ICARAS). Circulation. 2005 May 3;111(17):2203-9. Epub 2005 Apr 25.
• Sattar N, McCarey DW, Capell H, McInnes IB. Explaining how "high-grade" systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation. 2003 Dec 16;108(24):2957-63.
• de Leeuw K, Freire B, Smit AJ, Bootsma H, Kallenberg CG, Bijl M. Traditional and non-traditional risk factors contribute to the development of accelerated atherosclerosis in patients with systemic lupus erythematosus. Lupus. 2006;15(10):675-82.
• Atabek ME, Kurtoglu S, Pirgon O, Baykara M. Arterial wall thickening and stiffening in children and adolescents with type 1 diabetes. Diabetes Res Clin Pract. 2006 Oct;74(1):33-40. Epub 2006 Apr 18.
• Wadwa RP. Cardiovascular disease risk in youth with diabetes mellitus. Rev Endocr Metab Disord. 2006 Sep;7(3):197-204. Review.