Emine ATAĞ, Sevliya ÖCAL, Müferet ERGÜVEN

Ailevi Akdeniz Ateşi Tanısı ile İzlenen Prepubertal Çocuklarda Kemik Mineral Dansitesinin Değerlendirilmesi

Amaç: Ailevi Akdeniz Ateşi (AAA) otozomal ressesif kalıtılan tekrarlayan atateş, poliserözit ve cilt bulgularıyla karakterize atakler ve remisyonla seyreden kronik periyodik inflamatuvar bir hastalıktır. Bu çalışma, AAA tanısıyla izlenen prepubertal çocuklarda kemik mineral yoğunluğunu (BMD) araştırmak ve kemik yoğunluğu ve hastalığın laboratuvar ve demografik özelikleri arasındaki ilişkiyi saptamak amacıyla yapılmıştır. Gereç ve Yöntem: Bu çalışmaya AAA tanısıyla takipli ve kolşisin tedavisi alan prepubertal 32 hasta alındı. Hastaların demografik ve klinik verileri, remisyon döneminde akut faz reaktanları, kemik döngüsünün biyokimyasal parametreleri, kemik yaşı, L1-L4 vertebra BMD ölçümleri değerlendirildi. Hastaların sonuçları sağlıklı Türk çocukları için belirlenmiş olan değerlerle karşılaştırıldı. Bulgular: Hastaların tamamında z skorları -2’den büyüktü, akut faz değerleri, kemik metabolizma belirteçleri normal sınırlar içinde bulundu. aBMD Z-skor ile demografik veriler, akut fazlar ve kemik metabolizma belirteçleri arasında korelasyon saptanmadı.Tanıda gecikme süresi ve BMD arasın- da negatif korelasyon saptandı. Sonuç: AAA’li çocuklarda aBMD Z-skorları normal olmakla birlikte tanıya geç başlanılan çocuklarda BMD daha düşük bulundu. Erken başlanan kolşisin tedavisi bu hastalarda optimal kemik sağlığı için önemlidir.

Anahtar Kelimeler:

Çocuk, inflamasyon, kemik mineral dansitesi

Evaluation of Bone Mineral Density in Prepubertal Children with Familial Mediterranean Fever

Objective: Familial Mediterranean Fever (FMF) is a hereditary autosomal recessive chronic periodic inflammatory disease, characterized by recurrent fever polyserositis and skin manifestations. The aim of this study was to investigate the bone mineral density (BMD) in prepubertal children with FMF and to determine the relationship between bone density and demographic, laboratory characteristics of the disease. Material and Method: Thirty two previously diagnosed, attack-free, prepubertal FMF patients who were receiving regular colchicine treatment were included in the study. Demographic and clinical data of patients, acute phase reactants, biochemical parameters of bone turnover, bone age, and L1-L4 vertebral mineral density were evaluated. The results of the patients were compared with values determined for healthy Turkish children. Results: All of the patients had z-scores which were greater than -2. Acute phase values and bone metabolism markers were within normal limits. No correlation was found between the aBMD Z-score and demographic data, acute phase reactants and bone metabolism markers. There was a negative correlation between delay in diagnosis and aBMD Z- score. Conclusion: Although aBMD Z-scores were normal in children with FMF the aBMD Z score was found to be lower in children who had had a delay in treatment. Early initiated colchicine therapy is important for optimal bone health in these patients.

Keywords:

Bone mineral density, children, familial mediterranean fever,

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