Introduction

Familial Mediterranean fever (FMF) is auto-inflammatory disease presented by repeated episodes of fever and serositis. intestinal inflammation is a sub-clinical process occur during FMF attacks (1). Fecal calprotectin is a simple tool for assessment of the intestinal inflammation (2).

Aims & Methods

The aim was to assess the fecal calprotectin as new marker of FMF and predictor of response to colchicine.
Methods: We included patients diagnosed with FMF according to the Yalçınkaya criteria and confirmed by PCR for the gene in our outpatient clinic at Kafrelsheikh University Hospital between May 2020 and May 2022.Patients subjected to history taking, clinical and laboratory evaluation. We excluded patients with other causes of raised FC such as those who took NSAID or known to have IBD. The fecal Calprotectin was measured and level more than 50 μg/g were considered abnormal.

Results

we included 158 patients. Among them 102 patients were females, and 56 were males. Largest number of patients was diagnosed at age of twenties. Only 5 patients were diagnosed at fifties. 72 (45.57%) patients had more than 6 attacks. Attacks last in 73.42% of patients for less than 48 hours. About 60.76% patients had negative parent consanguinity and 18.99% patients had history of abdominal surgery. 130 patients had heterozygous mutation; 28 patients had homozygous mutations confirmed by PCR. Fecal calprotectin level at time of diagnosis between the two groups. Heterozygous group level was 69.92 ± 30.92 while Homozygous was 158.21 ± 47.33. the cut off value of Calprotectin level was 100 pg/ml had 96.40% sensitivity and 96.60% Specificity Calprotectin level have negative correlation with Colchicine dose needed.

Conclusion

Our result suggests faecal Calprotectin can by used among as predictors of FMF attacks and indictor for adequate colchicine response. fecal calprotectin levels may be used to screen severity intestinal inflammation in Homozygous and heterozygous.

References

1 Hentgen V, Grateau G, Kone-Paut I, et al. Evidence-based recommendations for the practical management of Familial Mediterranean Fever. Semin Arthritis Rheum 2013;43:387–91.
2 Roseth AG, Schmidt PN, Fagerhol MK. Correlation between faecal excretion of indium‐111‐labelled granulocytes and calprotectin, a granulocyte marker protein, in patients with inflammatory bowel disease.
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