Spondylitis and Arthritis in Familial Mediterranean Fever

MARAŞLI, Erdem; ozdolap, senay; SARIKAYA, Selda

Spondylitis and Arthritis in Familial Mediterranean Fever

Selda SARIKAYA, (Bülent Ecevit Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Zonguldak, Türkiye)

Şenay ÖZDOLAP, (Bülent Ecevit Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Zonguldak, Türkiye)

Erdem MARAŞLI (Bülent Ecevit Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Zonguldak, Türkiye)

Turkish Journal of Rheumatology(.)Archives of Rheumatology

2 0

Yıl: 2012 Cilt: 27 Sayı: 4 Sayfa Aralığı: 241 - 247 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Spondylitis and Arthritis in Familial Mediterranean Fever

Öz:

Amaç: Bu çalışmada ailesel Akdeniz ateşi (AAA) tanısı olan ve artrit/spondilit bulgusu ile takip edilen hastaların klinik özellikleri incelendi.Hastalar ve yöntemler: Kasım 2000 - Mart 2012 tarihleri arasında artrit veya inflamatuvar omurga ağrısı yakınması ile başvuran ve AAA tanısı konmuş 29 hastanın (12 erkek, 17 kadın; ort. yaş 26.1±11.2 yıl; dağılım 16-51 yıl) verileri retrospektif olarak incelendi. Hastaların yaş ve cinsiyetleri kaydedildi. Artrit/spondilit başlangıç yaşı, AAA tanı yaşı, ailede AAA öyküsü ve geçirilmiş cerrahi girişim öyküsü varlığının yanı sıra, periferik artriti bulunan hastaların tutulan eklem sayısı ve yeri de kaydedildi. Sakroiliit ve spondiliti bulunan hastalarda periferik artrit varlığı incelendi ve tedavide kullanılan ilaçlar kaydedildi. İnsan lökosit antijen (HLA)-B27 ve Akdeniz ateşi (MEFV) geni analizi yapılmış hastaların sonuçları kaydedildi.Bulgular: Artrit/spondilit başlangıç yaşı ortalama 20.4±9.1 yıl idi. Hastaların 24'ünde artrit (15'inde monoartrit, 9'unda oligoartrit) mevcuttu ve en sık etkilenen periferik eklem, ayak bileği idi (n=13). Beş hastada artritle birlikte spondilit, diğer beş hastada sadece spondilit mevcuttu. Dört hastada total kalça replasmanı, bir hastada diz debridmanı ve bir hastada apendektomi öyküsü vardı. Akdeniz ateşi geni analizi yapılan 27 hastanın 10'unda M694V homozigot mutasyonu (%37) saptandı ve total kalça replasmanı cerrahisi geçiren hastaların tümünde aynı mutasyon vardı. HLA-B27 gen incelemesi yapılan 21 hastanın ikisinde HLAB27 pozitif idi.Sonuç: Ailesel Akdeniz ateşi genç hastalarda inflamatuvar artrit ve spondilit ayırıcı tanısında mutlaka yer almalıdır. Klasik artrit atakları en sık görülen klinik tablo olsa da kronik eroziv eklem tutulumu ve spondilitin de bu hastalığın bir klinik görünümü olduğu akılda tutulmalıdır. Kolşisin tedavisi atakların ve amiloidozun önlenmesinde etkili olmakla birlikte, kronik eroziv artritlerde olduğu gibi romatolojik hastalıkların ağır formlarında kullanılan hastalık modifiye edici antiromatizmal ilaçlar (DMARD) ve biyolojik ilaçlar da etkin tedavi seçenekleri olarak görülmektedir

Anahtar Kelime:

Konular: Romatoloji

Ailesel Akdeniz Ateşinde Spondilit ve Artrit

Öz:

Objectives: This study aims to evaluate the clinical features of patients who are diagnosed with familial Mediterranean fever (FMF) and followed due to arthritis/spondylitis findings. Patients and methods: The data of 29 patients (12 males, 17 females; mean age 26.1±11.2 years; range 16 to 51 years) who presented with arthritis and/or inflammatory spinal pain and were diagnosed with FMF between November 2000 and March 2012 were retrospectively analyzed. The age and gender of the patients were recorded. The age of onset of arthritis/spondylitis, age at FMF diagnosis, family history of FMF, and previous surgical history as well as the number of affected joints and their localization were also recorded. The presence of peripheral arthritis in patients with sacroiliitis and spondylitis was also investigated, and the drugs used for treatment were recorded. The results were documented in patients who underwent human leukocyte antigen (HLA)-B27 and Mediterranean fever (MEFV) gene analysis. Results: The mean age of onset of arthritis/spondylitis was 20.4±9.1 years. Arthritis was observed in 24 of the patients (monoathritis in 15 patients, oligoarthritis in 9 patients), and the most affected peripheral joint was the ankle (n=13). Five patients had both arthritis and spondylitis while five others had only spondylitis. Four patients had a history of total hip replacement, one with knee debridement, and one with an appendectomy. The Mediterranean fever gene analysis was performed on 27 patients, and 10 of them (37%) had a M694V homozygous mutation, and those who had undergone total hip replacement had the same mutation. The HLA-B27 gene analysis was performed on 21 patients, and two of them tested positive. Conclusion: Familial Mediterranean fever should be included in the differential diagnosis of inflammatory arthritis and spondylitis in young patients. Classical arthritis attacks are the most common clinical presentation; however, chronic erosive joint involvement and spondylitis should be also recognized as clinical features of the disease. Although colchicine therapy is effective in preventing attacks and amyloidosis, both disease-modifying antirheumatic drugs (DMARDs) and biological drugs appear to be effective in treating severe forms of rheumatological disorders and chronic erosive arthritis

Anahtar Kelime:

Konular: Romatoloji

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	SARIKAYA S, ozdolap s, MARAŞLI E (2012). Spondylitis and Arthritis in Familial Mediterranean Fever. , 241 - 247.
Chicago	SARIKAYA Selda,ozdolap senay,MARAŞLI Erdem Spondylitis and Arthritis in Familial Mediterranean Fever. (2012): 241 - 247.
MLA	SARIKAYA Selda,ozdolap senay,MARAŞLI Erdem Spondylitis and Arthritis in Familial Mediterranean Fever. , 2012, ss.241 - 247.
AMA	SARIKAYA S,ozdolap s,MARAŞLI E Spondylitis and Arthritis in Familial Mediterranean Fever. . 2012; 241 - 247.
Vancouver	SARIKAYA S,ozdolap s,MARAŞLI E Spondylitis and Arthritis in Familial Mediterranean Fever. . 2012; 241 - 247.
IEEE	SARIKAYA S,ozdolap s,MARAŞLI E "Spondylitis and Arthritis in Familial Mediterranean Fever." , ss.241 - 247, 2012.
ISNAD	SARIKAYA, Selda vd. "Spondylitis and Arthritis in Familial Mediterranean Fever". (2012), 241-247.

APA	SARIKAYA S, ozdolap s, MARAŞLI E (2012). Spondylitis and Arthritis in Familial Mediterranean Fever. Turkish Journal of Rheumatology(.)Archives of Rheumatology, 27(4), 241 - 247.
Chicago	SARIKAYA Selda,ozdolap senay,MARAŞLI Erdem Spondylitis and Arthritis in Familial Mediterranean Fever. Turkish Journal of Rheumatology(.)Archives of Rheumatology 27, no.4 (2012): 241 - 247.
MLA	SARIKAYA Selda,ozdolap senay,MARAŞLI Erdem Spondylitis and Arthritis in Familial Mediterranean Fever. Turkish Journal of Rheumatology(.)Archives of Rheumatology, vol.27, no.4, 2012, ss.241 - 247.
AMA	SARIKAYA S,ozdolap s,MARAŞLI E Spondylitis and Arthritis in Familial Mediterranean Fever. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2012; 27(4): 241 - 247.
Vancouver	SARIKAYA S,ozdolap s,MARAŞLI E Spondylitis and Arthritis in Familial Mediterranean Fever. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2012; 27(4): 241 - 247.
IEEE	SARIKAYA S,ozdolap s,MARAŞLI E "Spondylitis and Arthritis in Familial Mediterranean Fever." Turkish Journal of Rheumatology(.)Archives of Rheumatology, 27, ss.241 - 247, 2012.
ISNAD	SARIKAYA, Selda vd. "Spondylitis and Arthritis in Familial Mediterranean Fever". Turkish Journal of Rheumatology(.)Archives of Rheumatology 27/4 (2012), 241-247.