Gizem SARI, Nafiye URGANCI, Gül ÖÇELİK, Merve USTA

AİLESEL AKDENİZ ATEŞİ TANISI İLE İZLENEN OLGULARIN ÜST GASTROİNTESTİNAL SİSTEM BULGULARININ DEĞERLENDİRİLMESİ

Giriş: Çeşitli gastrointestinal sistem yakınmaları ile başvuran ailesel akdeniz ateşi tanılı hastaların üstgastrointestinal sistem bulgularının değerlendirilmesi ve sonuçların, kontrol grubu ile karşılaştırılması.Gereç ve Yöntemler: Çalışmaya 2012-2016 yılları arasında çocuk gastroenteroloji polikliniğimize çeşitli gastrointestinal sistem yakınmaları ile yönlendirilen, ailesel akdeniz ateşi tanısı ile takipli 85 olgu ve polikliniğimize kronikkarın ağrısı yakınması ile başvuran 85 kontrol grubu olmak üzere toplam 170 olgu dahil edildi. Ailesel akdenizateşi tanılı hastaların atak durumu, laboratuvar sonuçları incelenerek dışlandı. Hastalar, üst gastrointestinalsistem endoskopi bulguları, histopatolojik inceleme sonuçları ve ailesel akdeniz ateşi gen analiz sonuçlarıaçısından retrospektif olarak değerlendirildi.Bulgular: Hasta grubunda anormal endoskopik bulgular, kontrol grubuna göre istatistiksel olarak anlamlı düşüksaptandı. Grupların histopatolojik bulgularında ise istatistiksel olarak anlamlı fark saptanmadı. Ailesel akdenizateşi tanılı hasta grubunda, antrumda Helikobakter Pylori pozitifliği, kontrol grubuna göre anlamlı olarak yükseksaptandı (p:0,003). Ailesel akdeniz ateşi tanılı hastaların 35’ inin FMF gen analiz sonucu değerlendirildi, en sıkR202Q heterozigot mutasyonuna rastlandı. Mutasyonlar ile endoskopik ve histopatolojik pozitif bulgular arasındaanlamlı bir ilişki saptanmadı.Sonuç: Ailesel akdeniz ateşi tanılı olguların üst gastrointestinal sistem patolojileri, kronik karın ağrısı olan olgularile karşılaştırıldığında anlamlı fark saptanmadı. Literatürdeki sonuçların aksine üst gastrointestinal sistemyakınmaları ile başvuran olgularda R202Q Heterozigot mutasyonu, en sık mutasyon olarak saptandı. Aileselakdeniz ateşi ile üst gastrointestinal sistem patolojileri arasındaki ilişkiyi daha net anlayabilmek için daha fazlasayıda olgu ile yapılacak daha geniş kapsamlı prospektif çalışmalara ihtiyaç duyulmaktadır.

EVALUATION OF UPPER GASTROINTESTINAL SYSTEM SYMPTOMS OF THE FAMILIAL MEDITERRANEAN FEVER DIAGNOSED PATIENTS

Introduction: The objective of this study is to evaluate the gastrointestinal system findings in the children with Familial Mediterranean Fever disease and to compare the results with the control group. Materials and Methods: One hundred and seventy (170) cases were included in the study in which the eighty five (85) of them had been followed and diagnosed with Familial Mediterranean Fever by various authorities and directed to our pediatric gastroenterology and nutrition clinic on various gastrointestinal system complaints. Likewise, eighty five (85) control group cases were chosen from the same clinical environment with chronic abdominal pain. We excluded the Familial Mediterranean Fever attack state of the Familial Mediterranean Fever diagnosed group by seeking the blood test results. The results of upper gastrointestinal tract endoscopy findings, hystopathological findings and Familial Mediterranean Fever mutation analyzes are seeked retrospectively. Results: Abnormal endoscopy events of the upper gastrointestinal tract were observed significantly lower in Familial Mediterranean Fever diagnosed group when compared with controls. There were no statistically significant difference in abnormal hystophatological findings in the groups. The existence of Helicobacter pyloriin antrum was found significantly increased (p=0,003) in Familial Mediterranean Fever diagnosed group as compared with control group. We evaluate the Familial Mediterranean Fever mutation analyze results of thirty five subjects of the Familial Mediterranean Fever diagnosed group. The most widespread one was found to be the R202Q heterozygote mutation. There were not any significant correlation observed between the mutation types and the abnormal endoscopy and hystophatological outcomes. Conclusions: In our study, we did not observe any significant difference in abnormal findings of the upper gastrointestinal tract in Familial Mediterranean Fever diagnosed group when compared with the group complained of chronic abdominal pain. Unlike the findings in literature, the most frequent mutation was found to be the R202Q heterozygote mutation in the cases with upper gastrointestinal tract complaints. Prospective studies on a larger scale with higher number of cases are required in order to clarify the correlation between Familial Mediterranean Fever and upper gastrointestinal system pathologies in detai

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