Changes in Cerebral Blood Flow in Patients with Familial Mediterranean Fever

Abstract

INTRODUCTIONFamilial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by repeated attacks of fever, abdominal pain, pleuritic chest pain, and arthritis. The occurrence of nervous system manifestations in FMF is rare and their association with FMF is still uncertain (1,2). Additional neurologic disorders have been reported in FMF, such as posterior reversible encephalopathy syndrome (PRES), demyelinating lesions, and ischemic stroke (3,4,5). Attacks of FMF with clinical inflammation are only the tip of the iceberg (6). Increases in clinical and subclinical inflammation in FMF might lead to susceptibility to vascular comorbidities such as atherosclerosis, heart disease, and life-threatening secondary systemic amyloidosis due to endothelial dysfunction in FMF patients (7,8). The aim of this study was to assess cerebral blood flow velocities using transcranial Doppler (TCD) ultrasonography in patients with FMF. METHODSA total of 30 consecutively admitted patients aged from 20 to 50 years with a diagnosis of FMF who fulfilled the Livneh criteria for FMF were enrolled in the FMF group. The non-FMF group consisted of 30 age-and sex-matched randomly selected patients who did not have any risk factors for atherosclerosis, such as diabetes, hypertension, and coronary artery disease. All patients with FMF were using colchicine and were not in an attack period. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured. Consent was obtained from the local ethics committee, and all participants gave formal consent.TCD ultrasonography examination was performed with a Multidop X DWL TCD device after the patient had rested for 10 minutes in the supine position. The right and left middle cerebral arteries (MCAs) were insonated from the temporal windows at a depth of 50-65 mm with 2 MHz pulsed Doppler probes. Bilateral peak-systolic, end-diastolic, and mean blood flow velocities in the MCA, pulsatility index values, and resistance index values were recorded. The results for the FMF group were compared with the results for the non-FMF group. Statistical AnalysisThe data were analyzed using the Statistical Package for the Social Sciences 15.0 program (SPSS Inc.; Chicago, IL, USA). A paired t-test and cross-tabs tests were used for statistical analysis, and a value of p<0.05 was considered to be significant.

Cerebrovascular manifestations of familial Mediterranean fever

“…В одном исследовании [11] продемонстрировано повышение скорости церебрального кровотока при транскраниальной доплерографии у пациентов с ПБ, что авторы связывают с доклиническими атеросклеротическими изменениями. С учетом молодого возраста пациентов (не старше 40 лет) это может свидетельствовать о роли аутовоспаления в инициации цереброваскулярной патологии при ПБ.…”