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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
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated