The value of the levels of acute phase reactants for the prediction of familial Mediterranean fever associated amyloidosis: a case control study.
Özet
t In order to determine the role of levels of
acute phase proteins (APPs) for the development of
amyloidosis in familial Mediterranean fever (FMF)
patients, the levels of serum amyloid A (SAA), C reactive protein (CRP), Wbrinogen and erythrocyte sedimentation rate were measured in paired sera of 36
FMF patients during and in between acute attacks, 39
of their healthy parents (obligate heterozgotes), and 15
patients with FMF associated amyloidosis. To compare
the levels of APPs, 39 patients with chronic infections
or inXammatory diseases who may develop secondary
amyloidosis, 20 patients with acute infections who are
known to have elevated acute phase response but will
never develop amyloidosis and 19 healthy controls
were included. The median levels of all APPs are
increased in the patients with FMF during attacks and
a signiWcant decrease was observed after the attack was
over. The level of SAA was above reference range in
all FMF patients during the attack free period and the
level of at least one other APP was also above normal
in 64% of the patients. Both CRP and SAA levels were
found to be higher in obligate heterozygotes compared
to controls. The levels of SAA in patients with FMF
during the attack-free period, obligate heterozygotes
and patients with FMF-amyloidosis were found to be
similar. The levels in each group were found to be
higher than SAA levels found in healthy controls yet
lower than the levels measured in the patients with
acute infections and patients with chronic inXammation or chronic infections. In conclusion, our results
show that SAA level reXects subclinical inXammation
with high sensitivity but its value for the prediction of
amyloid formation process seems to be low.