Orhan KÜÇÜKŞAHİN, Ahmet OMMA, Sevinç Can SANDIKÇI, Mehmet Emin ENECİK, Yaşar KARAASLAN, Seda ÇOLAK

Ailevi Akdeniz Ateşinde Eritrosit Dağılım Genişliği Kolşisin Direncinin Bir Belirleyicisi Olabilir mi?

Amaç: Ailevi Akdeniz Ateşi hastalarında atak döneminde ve kolşisin direnci olan hastalarda eritrosit dağılım genişliğinin klinik kullanımını değerlendirmeyi amaçladık. Yöntem ve Gereçler: 197 FMF hastası ve 111 sağlıklı kontrol calışmaya alındı. FMF hastaları; atak ve atak dışı dönem, kolşisin direnci olanlar ve kolşisin direnci olmayanlar olarak gruplara ayrıldı. RDW, diğer bilinen sistemik inflamasyon belirteçleri (MPV, NLR, ESR, CRP) ve hastaların klinik özellikleri incelendi. Bulgular: ESR, CRP, NLR ve RDW seviyeleri FMF grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu [ESR için 14 ve 7 , p < 0.001, CRP için 8 ve 2 , p < 0.001, NLR için 2.1 (0.7-27.2) ve 1.8 (0.8-6.8), p=0.03, RDW için 14.5±1.9 ve 13.4±1.0, p< 0.001]. FMF atağı olan hastalarda ataksız hastalara kıyasla ESR, CRP, NLR ve RDW değerleri anlamlı olarak yüksek saptandı [ESR için 31 ve 10 , p< 0.001, CRP için 24 ve 5 , p < 0.001, NLR için 2.8 (1.0-8.1) ve 2.0 (0.7-27.2), p=0.002, RDW için 15.0±2.1ve 15.0±2.1, p= 0.04]. Yine Cr-FMF hastalarında Cnr- FMF hastalara kıyasla ESR, CRP, RDW ve NLR anlamlı olarak yüksek saptandı [ESR için 32 ve 12 , p< 0.001, CRP için 22.5 ve 6 , p< 0.001, RDW için 15.5±2.2 ve 14.4±1.8, p= 0.004, NLR için 2.6 (1.1-7.1) ve 2.0 (0.7-27.2), p= 0.02 ]. Korelasyon analizleri serum RDW ile ESR değerleri arasında pozitif korelasyon olduğunu gösterdi (r=0.28, p

Can the Red Cell Distribution Width be a Predictor of Colchicine Resistance in Familial Mediterranean Fever?

Aim:In this study we aimed to assess the clinical utility of the Red Cell Distribution Width (RDW) in predicting colchicine resistance in Familial Mediterranean Fever (FMF) patients.Material and Methods: 197 FMF and 111 healthy controls (HC) were enrolled to the study. FMF patients were grouped into two according to FMF with attack, FMF with attack free period, colchicine resistance FMF (Cr-FMF), colchicine non resistance FMF (Cnr-FMF) and laboratory parameters were compared between them. The associations between RDW and other known indicators of systemic inflammation [Mean Platelet Volüme (MPV), Neutrophil to Lymphocyte Ratio (NLR), Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP)] and patient clinical characteristics were investigated. Results: ESR, CRP, NLR and RDW levels were found to be significantly higher in the FMF group than the control group [14 vs 7 , p < 0.001 for ESR, 8 vs 2 , p < 0.001 for CRP, 2.1 (0.7-27.2) vs 1.8 (0.8-6.8), p=0.03 for NLR, 14.5±1.9 vs13.4±1.0, p< 0.001 for RDW]. ESR, CRP, NLR and RDW were higher in the attack group than attack free group [31 vs 10 , p< 0.001 for ESR, 24 vs 5 , p < 0.001 for CRP, 2.8 (1.0-8.1) vs 2.0 (0.7-27.2), p=0.002 for NLR, 15.0±2.1vs 15.0±2.1, p= 0.04 for RDW]. ESR, CRP, RDW and NLR values were higher in Cr-FMF group than the Cnr- FMF group [32 vs 12 , p< 0.001 for ESR, 22.5 vs 6 , p< 0.001 for CRP, 15.5±2.2 vs 14.4±1.8, p= 0.004 for RDW, 2.6 (1.1-7.1) vs 2.0 (0.7-27.2), p= 0.02 for NLR]. Correlation analysis showed a positive correlation between serum RDW levels and ESR value (r=0.28, p

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1. Yılmaz E, Dinçel N, Sözeri B, et al. Familial Mediterranean fever in children from the Aegean region of Turkey: gene mutationfrequencies and phenotype-genotype correlation. Turk J Med Sci. 2015;45(6):1198-206.
2. Kucuk A, Gezer IA, Ucar R, Karahan AY. Familial mediterranean fever. Acta Med (Hradec Kralove). 2014; 57:97–104.
3. Erer B, Demirkaya E, Ozen S, Kallinich T. What is the best acute phase reactant for familial Mediterranean fever follow-up and its role in the prediction of complications? A systematic review. Rheumatol Int. 2016 Apr;36(4):483-7.
4. Sahin S, Senel S, Ataseven H, Yalcin I. Does mean platelet volume influence the attack or attack-free period in the patients with Familial Mediterranean fever?. Platelets. 2013 ; 24:320–323.
5. Hu ZD, Sun Y, Guo J, et al. Red blood cell distribution width and neutrophil/lymphocyte ratio are positively correlated with disease activity in primary Sjögren’s syndrome. Clin Biochem. 2014; 47: 287–90.
6. Danese E, Lippi G, Montagnana M. Red blood cell distribution 7. Ipek S, Cekic C, Alper E, et al. Can red cell distribution width be a marker of disease activity in ulcerative colitis ?. Int J Clin Exp Med. 2015; 15:13848-53.
8. Ay S, Eryilmaz MA, Aksoy N, Okus A, Unlu Y, Sevinc B. Is Early Detection of Colon Cancer Possible with Red Blood Cell Distribution Width?. Asian Pac J Cancer Prev. 2015;16(2):753-6.
9. Özer S, Yılmaz R, Sönmezgöz E , et al. Simple Markers for Subclinical Inflammation in Patients with Familial Mediterranean Fever. Med Sci Monit. 2015 ;21: 298–303.
10. Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest. 2005 Dec;115(12):3378-84.
11. Alan S, Tuna S, Türkoğlu EB. The relation of neutrophil-tolymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume with the presence and severity of Behçet’s syndrome. Kaohsiung J Med Sci. 2015 Dec;31(12):626-31.
12. Wang M, Zhang J, Ji Q, et al. Evaluation of platelet distribution width in chronic obstructive pulmonary disease patients with pulmonary embolism. Biomark Med. 2015 Nov 16. [Epub ahead of print]
13. Ben-Zvi I, Livneh A. Chronic inflammation in FMF markers, risk factors, outcomes and therapy. Nat Rev Rheumatol. 2011 Feb;7(2):105-12.
14. Goldfinger SE . Colchicine for familial Mediterranean fever. N Engl J Med. 1972 Dec 21;287(25):1302.
15. Ozkan E, Okur O, Ekmekci A, Ozcan R, Tag T . A new approach to the treatment of periodic fever. Med Bull Istanb 1972; 5:44–49. 16. Montagnana M, Cervellin G, Meschi T, Lippi G. The role of red cell distribubion with in cardiovascular and thrombotic disorders. Clin Chem Lab Med. 2011 Dec 17;50(4):635-41.
17. Patel KV, Semba RD, Ferrucci L, et al. Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A BiolSci Med Sci, 2009;65,:258-65.
18. Rhodes CJ, Howard LS, Busbridge M, et al. Iron deficiency and raised hepcidin in idiopathic pulmonary arterial hypertension: clinical prevalence, outcomes, and mechanistic insights. J Am Coll Cardiol. 2011 Jul 12;58(3):300-9.
19. de Gonzalo-Calvo D, de Luxán-Delgado B, Rodríguez-González S, et al. Cytokine. 2012 May;58(2):193-8.
20. Mentese U, Dogan OV, Turan I, et al. Oxidant-antioxidant balance during on-pump coronary artery bypass grafting. Scientific World Journal 2014; 2014: 263058.
21. Friedman JS, Lopez MF, Fleming MD, et al. SOD2- deficiency anemia: protein oxidation and altered protein expression reveal targets of damage, stress response, and antioxidant responsiveness. Blood. 2004 Oct 15;104(8):2565-73.
22. Jablonska M, Sztanke M, Pasternak K. Changes in antioxidant enzyme activities in erythrocytes in patients undergoing CABG – a pilot study. Applied Cardiopulmonary Pathophysiology 2008; 12: 13–19.
23. Semba RD, Patel KV, Ferrucci L, et al. Serum antioxidants and inflammation predict red cell distribution width in older women: The Women’s Health and Aging Study I. Clin Nutr. 2010 Oct;29(5):600-4.
24. Ferrucci L, Guralnik JM, Woodman RC, et al. Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med. 2005 Nov;118(11):1288.
25. Allen LA, Felker GM, Mehra MR, et al. Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail. 2010 Mar;16(3):230-8.
26. Heymans S, Hirsch E, Anker SD, et al. Inflammation as a therapeutic target in heart failure? A scientific statement from the Translational Research Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2009 Feb;11(2):119-29.
27. Pascual-Figal DA, Bonaque JC, Redondo B, et al. Red blood cell distribution width predicts long-term outcome regardless of anaemia status in acute h eart failure patients. Eur J Heart Fail. 2009 Sep;11(9):840-6.
28. Aktürk S, Aktürk E, Kurtoğlu E, Kaya A, Gülkesen A, et al. (2012) Association between Red Cell Distribution Width and Disease Activity in Patients with Behcet’s Disease. J Clin Exp Cardiolog 3:211.
29. Lee WS, Kim T. Relation between red blood cell distribution width and inflammatory biomarkers in rheumatoid arthritis. Arch Pathol Lab Med. 2010 Apr;134(4):505-6.
30. Farkas N, Szabó A, Lóránd V, et al. Clinical usefulness of measuring red blood cell distribution width in patients with systemic sclerosis. Rheumatology (Oxford). 2014 Aug;53(8):1439-45.
31. Rodríguez-Carrio J, Alperi-López M, López P, Alonso-Castro S, Ballina-García FJ, Suárez A. Red cell distribution width is associated with cardiovascular risk and disease parameters in rheumatoid arthritis. Rheumatology (Oxford). 2015 Apr;54(4):641-6.
32. Hu ZD, Chen Y, Zhang L, et al. Red blood cell distribution width is a potential index to assess the disease activity of systemic lupus erythematosus. Clin Chim Acta. 2013 Oct 21;425:202-5.
33. Yeşil A, Senateş E, Bayoğlu IV, Erdem ED, Demirtunç R, Kurdaş Övünç AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011 Dec;5(4):460-7.
34. Ahsen A, Ulu MS, Yuksel S, et al. As a New Inflammatory Marker for Familial Mediterranean Fever: Neutrophil-to-Lymphocyte Ratio. Inflammation. 2013 Dec;36(6):1357-62.
35. Yildirim Cetin G, Gul O, Kesici-Metin F, Gokalp İ, SayarlıogluM. Evaluation of the Mean Platelet Volume and Red Cell Distribution Width in FMF: Are They Related to Subclinical Inflammation or Not? Int J Chronic Dis. 2014;2014:127426