Erişkin Ailevi Akdeniz Ateşi Hastalarında Ataksız Dönemdeki Serum Amiloid A’nın Diğer İnflamatuar Belirteçlerle Korelasyonu

Yıl 2021, Cilt: 43 Sayı: 6, 609 - 616, 24.09.2021

Hasan Sözel , Fatih Yılmaz , Esin Avşar , Emir Maştaoğlu Mustafa Serkan Alemdar , Feyza Bora

https://doi.org/10.20515/otd.938690

Öz

Bu çalışmanın amacı Ailevi Akdeniz Ateşi (FMF) olan hastalarda ataksız dönemde serum amiloid A (SAA) ile klinik pratikte sık kullanılan diğer inflamatuar belirteçler arasındaki ilişkinin değerlendirilmesidir.Bu çalışmaya FMF tanısı olan 90 hasta (38 erkek, 52 kadın) dahil edildi. FMF tanısı Tel-Hashomer kriterlerine göre konuldu. Hastalar SAA düzeyine göre iki gruba ayrıldı. Grup 1: yüksek SAA (>6.4 mg/dL), Grup 2: normal SAA (≤6.4 mg/dL). Gruplarda SAA düzeyleri ile diğer inflamatuar belirteçler arasındaki korelasyon değerlendirildi. Çalışamaya dahil edilen 90 hastanın %56.7’sinin SAA değeri >6.4 mg/dL ve %43.3’ünün ≤6.4 mg/dL’ydi. Grupların serum kreatinin, tahmini glomerüler filtrasyon hızı, ürik asit, albumin, lökosit, lenfosit ve platelet sayısı ile Platelet/Lenfosit oranı (PLO) açısından anlamlı farklılık gözlenmedi. Grup 1’in ortalama fibrinojen, C-reaktif protein (CRP), eritrosit sedimentasyon hızı (ESH), Nötrofil/Lenfosit oranın (NLO) ve CRP/albümin değerleri grup 2’den istatistiksel olarak daha yüksek ve hemoglobin ortalaması ise daha düşük saptandı. Grup 1’in ortalama nötrofil ve monosit sayısı grup 2’den daha yüksekti ancak bu fark istatistiksel açıdan anlamlı değildi. SAA ile CRP arasında pozitif yönde güçlü, ESH ve CRP/albümin ile pozitif yönde orta, ve lökosit sayısı ve NLO arasında pozitif yönde zayıf bir korelasyon saptandı. CRP düzeyi FMF hastalarında ataksız dönemde SAA ile en yüksek korelasyonu göstermesi nedeniyle SAA düzeylerinin değerlendirilemediği durumlarda hastalık aktivitesi ve subklinik inflamasyonu öngörmek için kullanılabilir

Anahtar Kelimeler

Ailevi Akdeniz Ateşi, Serum Amiloid A, İnflamatuar Belirteçler, İnflamasyon

Destekleyen Kurum

Çalışmamıza herhangi bir kurum desteği olmamıştır.

Correlation of Serum Amyloid A in the Attack-Free Period with Other Inflammatory Markers in Adult Familial Mediterranean Fever Patients

Öz

The aim of this study is to evaluate the relationship between serum amyloid A (SAA) and other inflammatory markers frequently used in clinical practice in patients with Familial Mediterranean Fever (FMF).Ninety patients (38 males, 52 females) with a diagnosis of FMF were included in this study. FMF diagnosis was made according to Tel-Hashomer criteria. The patients were divided into two groups according to their SAA levels. Group 1:high SAA (>6.4 mg/dL), Group 2:normal SAA (≤6.4 mg/dL). The correlation between SAA levels and other inflammatory markers in the groups was evaluated.Of the 90 patients included in the study, 56.7% had SAA value>6.4 mg / dL and 43.3% had ≤6.4 mg/dL. There was no significant difference between the groups in terms of serum creatinine, estimated glomerular filtration rate, uric acid, albumin, leukocyte, lymphocyte and platelet counts and platelet/lymphocyte ratio (PLR). The average fibrinogen, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophil/lymphocyte ratio (NLR) and CRP/albumin values in group 1 were statistically higher than group 2, and the mean hemoglobin was lower. The mean neutrophil and monocyte count of group 1 was higher than group 2, but this difference was not statistically significant. There was a strong positive correlation between SAA and CRP, moderate positively with ESR and CRP/albumin, and a weak positive correlation between leukocyte count and NLR.Since the CRP level shows the highest correlation with SAA during the attack-free period in FMF patients, it can be used to predict disease activity and subclinical inflammation in cases where SAA levels cannot be evaluated.

Anahtar Kelimeler

Familial Mediterranean Fever, Serum Amyloid A, Inflammatory Markers, Inflammation

Kaynakça

• Üstebay S, Üstebay D, Yılmaz Y. Ailevi Akdeniz Ateşi. JAREM 2015; 5: 89-93
• Özen S, Batu ED, Demir S. Familial Mediterranean Fever: Recent Developments in Pathogenesis and New Recommendations for Management. Front Immunol. 2017;8:253.
• Ben-Zvi I, Livneh A. Chronic inflammation in FMF: Markers, risk factors, outcomes and therapy. Nat Rev Rheumatol. 2011;7(2):105-112.
• Yalçinkaya F, Çakar N, Acar B, et al. The value of the levels of acute phase reactants for the prediction of familial Mediterranean fever associated amyloidosis: A case control study. Rheumatol Int. 2007;27(6):517-522.
• Fassbender K, Dempfle CE, Mielke O, et al. Proinflammatory cytokines: Indicators of infection in high-risk patients. J Lab Clin Med. 1997;130(5):535-539.
• Manukyan GP, Ghazaryan KA, Ktsoyan ZA, et al. Cytokine profile of Armenian patients with Familial Mediterranean fever. Clin Biochem. 2008 Jul;41(10-11):920-922.
• Tunca M, Kirkali G, De Soytürk M, et al. Acute phase response and evolution of familial Mediterranean fever. Lancet. 1999;353(9162):1415.
• Ahsen A, Ulu MS, Yuksel S, et al. As a new inflammatory marker for familial mediterranean fever: Neutrophil-to-lymphocyte ratio. Inflammation. 2013 Dec;36(6):1357-1362.
• Sakallı H, Kal Ö. Mean platelet volume as a potential predictor of proteinuria and amyloidosis in familial Mediterranean fever. Clin Rheumatol. 2013;32(8):1185-1190.
• Akbas EM, Demirtas L, Ozcicek A, et al. Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy. Int J Clin Exp Med. 2014;7(7):1794-1801.
• Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5-14.
• Özer S, Yılmaz R, Sönmezgöz E, et al. Simple markers for subclinical inflammation in patients with familial mediterranean fever. Med Sci Monit. 2015;21:298-303.
• Yüksel S, Ekim M, Özçakar ZB, et al. The value of procalcitonin measurements in children with familial Mediterranean fever. Rheumatol Int. 2012;32(11):3443-3447.
• Yüksel S, Karadağli E, Evrengül H, et al. Could pentraxin-3 be a new marker for subclinical inflammation in familial Mediterranean fever? Pediatr Rheumatol. 2015, 13(1):P98
• Schattner A, Lachmi M, Livneh A, et al. Tumor necrosis factor in familial Mediterranean fever. Am J Med. 1991;90(4):434–438.
• Gang N, Drenth JPH, Langevitz P, et al. Activation of the cytokine network in familial Mediterranean fever. J Rheumatol. 1999 Apr;26(4):890-897
• Akkececi NS, Cetin GY, Gogebakan H, et al. The C-reactive protein/albumin ratio and complete blood count parameters as indicators of disease activity in patients with takayasu arteritis. Med Sci Monit. 2019;25:1401–1409.
• Gibson DJ, Hartery K, Doherty J, et al. CRP/Albumin Ratio: An Early Predictor of Steroid Responsiveness in Acute Severe Ulcerative Colitis. J Clin Gastroenterol. 2018;52(6):48–52.
• Berkun Y, Eisenstein EM. Diagnostic criteria of familial Mediterranean fever. Autoimmun Rev. 2014;13(4-5):388-390.
• Savic S, Dickie LJ, Wittmann M, et al. Autoinflammatory syndromes and cellular responses to stress: Pathophysiology, diagnosis and new treatment perspectives. Best Pract Res Clin Rheumatol. 2012;26(4):505-533.
• Savran Y, Sari I, Leyla Kozaci D, et al. Increased levels of macrophage migration inhibitory factor in patients with familial mediterranean fever. Int J Med Sci. 2013;10(7):836-839.
• Berkun Y, Padeh S, Reichman B, et al. A Single Testing of Serum Amyloid A Levels as a Tool for Diagnosis and Treatment Dilemmas in Familial Mediterranean Fever. Semin Arthritis Rheum. 2007;37(3):182-188.
• Guzel S, Andican G, Seven A, et al. Acute phase response and oxidative stress status in familial mediterranean fever (FMF). Mod Rheumatol. 2012;22(3):431-437.
• Uslu AU, Deveci K, Korkmaz S, et al. Is neutrophil/lymphocyte ratio associated with subclinical inflammation and amyloidosis in patients with familial mediterranean fever? Biomed Res Int. 2013;2013:185317.
• Bilginer Y, Akpolat T, Ozen S. Renal amyloidosis in children. Pediatr Nephrol. 2011;26(8):1215-1227.
• Baykal Y, Saglam K, Yilmaz MI, et al. Serum sIL-2r, IL-6, IL-10 and TNF-alpha level in familial Mediterranean fever patients. Clin Rheumatol. 2003;22(2):99-101.
• Yildirim K, Uzkeser H, Keles M, et al. Relationship between serum interleukin-1beta levels and acute phase response proteins in patients with familial Mediterranean fever. Biochem medica. 2012;22(1):109–113.
• Kiliçaslan B, Dursun H, Kaymak S, et al. The relationship between neutrophil to lymphocyte ratio and blood pressure variability in hypertensive and normotensive subjecs. Turk Kardiyol Dern Ars. 2015;43(1):18-24.
• El Shafey WEH, Emara AM, Mosa WF, et al. Predictive Value of Neutrophil-to-Lymphocyte Ratio in Outcomes of Patients with Acute Coronary syndrome. Atheroscler Suppl. 2019; 6(1):4
• Farshchian N, Soleimani M, Heydarheydari S, et al. Survey of neutrophil to lymphocyte ratio as prognostic factor in colorectal cancer. Middle East Journal of Cancer, 2019;10(4):319-323.
• Buyukkaya E, Karakaş MF, Karakaş E, et al. Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome. Clin Appl Thromb Hemost. 2014;20(2):159-163.
• Faria SS, Fernandes PC, Silva MJB, et al. The neutrophil-to-lymphocyte ratio: A narrative review. Ecancermedicalscience. 2016;10:702.
• Çakan M, Karadağ ŞG, Tanatar A, et al. The Value of Serum Amyloid A Levels in Familial Mediterranean Fever to Identify Occult Inflammation During Asymptomatic Periods. J Clin Rheumatol. 2021;27(1):1–4.