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Are MEFV mutations susceptibility factors in enthesitis-related arthritis patients in the eastern Mediterranean?
[familial mediterranean fever]
Enthesitis-related
arthritis
(
ERA
)
,
is
a
complex
genetic
disease
.
Although
HLA-B
27
is
well
established
,
it
does
not
explain
all
the
genetic
load
in
ERA
.
Familial
Mediterranean
fever
(
FMF
)
,
caused
by
mutations
in
the
MEFV
gene
,
is
a
frequent
autoinflammatory
disorder
in
the
eastern
Mediterranean
.
We
investigated
the
clinical
and
imaging
features
of
53
ERA
patients
,
as
well
as
the
frequency
of
MEFV
gene
mutations
in
those
who
were
HLA-B
27
negative
.
The
mean
age
of
the
patients
was
13
.
3
±
2
.
2
years
and
49
were
boys
.
Peripheral
arthritis
was
present
in
all
and
sacroiletis
in
26
patients
.
Ultrasonography
showed
enthesitis
in
6
patients
of
the
tendons
,
whereas
these
were
assessed
to
be
normal
by
physical
examination
.
Forty
patients
(
75
.
5
%
)
were
positive
for
HLA-B
27
.
MEFV
analysis
was
performed
for
patients
who
were
HLA-B
27
negative
.
One
patient
refused
MEFV
analysis
.
9
patients
carried
MEFV
mutations
:
2
patients
were
homozygous
for
M
694
V
(
both
patients
were
subsequently
started
colchicine
along
with
ERA
treatment
)
,
5
patients
were
heterozygous
for
M
694
V
mutation
,
1
patient
was
heterozygous
for
E
148
Q
,
and
1
patient
was
heterozygous
for
K
695
R
mutation
.
None
of
the
patients
had
features
suggesting
FMF
at
diagnosis
of
ERA
;
1
patient
subsequently
developed
typical
FMF
attacks
.
Our
findings
suggest
that
MEFV
mutations
may
represent
a
susceptibility
factor
for
ERA
in
the
populations
of
the
eastern
Mediterranean
.
Diseases
Validation
Diseases presenting
"arthritis"
symptom
acute rheumatic fever
child syndrome
congenital adrenal hyperplasia
cystinuria
familial hypocalciuric hypercalcemia
familial mediterranean fever
focal myositis
harlequin ichthyosis
homocystinuria without methylmalonic aciduria
inclusion body myositis
lamellar ichthyosis
malignant atrophic papulosis
pyomyositis
sneddon syndrome
trochlear dysplasia
typhoid
wiskott-aldrich syndrome
This symptom has already been validated