Familial Mediterranean fever in Armenian children with inflammatory bowel disease

Inflammatory bowel disease (IBD) and familial Mediterranean fever (FMF) are inflammatory diseases with complex interactions among genetic, immune, and environmental factors. FMF is a monogenic autoinflammatory disease, characterized by recurrent febrile attacks and polyserositis, and is manifested m...

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Published inFrontiers in pediatrics Vol. 11; p. 1288523
Main Authors Amaryan, Gayane, Sarkisian, Tamara, Tadevosyan, Artashes, Braegger, Christian
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 12.02.2024
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Summary:Inflammatory bowel disease (IBD) and familial Mediterranean fever (FMF) are inflammatory diseases with complex interactions among genetic, immune, and environmental factors. FMF is a monogenic autoinflammatory disease, characterized by recurrent febrile attacks and polyserositis, and is manifested mainly in childhood. FMF is widespread in Armenia. There are reports on the concurrent occurrence of FMF and IBD. gene mutations may have a disease-modifying effect on IBD. We have investigated the frequency of mutations and FMF in Armenian children with IBD and their influence on the clinical course. A total of 69 untreated IBD patients under 18 years of age were enrolled: 52.1% (36) had ulcerative colitis (UC), 21.7% (15) had Crohn's disease (CD), and 26.0% (18) had unclassified colitis (IBD-U). The frequency of FMF among them was 36.2% (25/69), and mutations were identified in 53.6% (37/69). The highest rate of mutations and FMF was in UC patients (61.1% and 41.6% respectively). In all, 56.7% (21/37 of IBD patients with mutations had mutated alleles, mainly in compound heterozygous and heterozygous states. There were no associations in the group of IBD patients with coexisting FMF (25), either between any mutation and type of IBD or coexistence of FMF. Overall, 36.0% (9/25) of them developed VEO IBD and carried mainly the mutation. We concluded that the carrier frequency of mutations among Armenian pediatric IBD patients was rather high (53.6%), especially for UC. It was suggested that the MEFV gene is not necessarily a susceptibility gene but most likely modifies the course of IBD. genetic testing was recommended for Armenian pediatric IBD patients, especially for VEO UC and IBD-U, atypical IBD course, or resistance to the conventional treatment. They should also be asked for isolated febrile attacks, recurrent arthritis, and family history, even in the absence of FMF typical symptoms, to rule out FMF and its complications.
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Edited by: Matthew Wyatt Carroll, University of Alberta, Canada
Reviewed by: Efimia Papadopoulou-Alataki, Aristotle University of Thessaloniki, Greece
Abbreviations Arabkir MC- ICAH, “Arabkir” Medical Complex- Institute of Child and Adolescent Health; CD, Crohn's disease; CI, confidence interval; CMG, Center of Medical Genetics; ESPGHAN, European Society for Paedriatic Gastroenterology, Hepatology, and Nutrition; FMF, Familial Mediterranean fever; HPFS, hereditary periodic fever syndromes; IBD, Inflammatory bowel disease; IBD-U, Unclassified colitis; MEFV, Mediterranean Fever; NPC FMF, FMF National Pediatric Centre for FMF; P-value, statistical significance; PCDAI, Pediatric Crohn's Disease Activity Index; PC, polymeraze chest reaction; PUCAI, Pediatric Ulcerative Colitis Activity Index; SD, standard deviation; VEO IBD, very early-onset inflammatory bowel disease; UC, ulcerative colitis; YSMU, Yerevan State Medical University.
Ozgur Kasapcopur, Istanbul University-Cerrahpasa, Türkiye
ISSN:2296-2360
2296-2360
DOI:10.3389/fped.2023.1288523