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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
"enthesitis"
symptom
familial mediterranean fever
This symptom has already been validated