儿童家族性地中海热

IF 1.3 Q3 PEDIATRICS Turkish archives of pediatrics Pub Date : 2024-11-01 DOI:10.5152/TurkArchPediatr.2024.24188
Rabia Miray Kisla Ekinci, Elif Kilic Konte, Nergis Akay, Umit Gul
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引用次数: 0

摘要

家族性地中海热(FMF)是最常见的单基因自身炎症性疾病,以反复发热和血清炎为特征。它主要影响地中海后裔,包括阿拉伯人、亚美尼亚人、土耳其人和犹太人。导致 FMF 的地中海热(MEFV)基因于 1997 年被发现。双倍拷贝致病变体会导致吡咯啉炎症小体过度激活,从而引发炎症。临床表现包括反复发热、腹痛和关节受累,发作一般持续 12-72 小时。诊断依据临床标准,并辅以基因检测。秋水仙碱是主要的治疗药物,可减少发作频率,预防肾淀粉样变性等并发症。尽管人们对 FMF 的认识(包括其遗传基础和治疗方案)有所进步,但在将其与其他自身炎症性疾病区分开来方面仍存在挑战。幼年特发性关节炎和炎症性肠病等并存疾病在 FMF 患者中很常见。正在进行的研究应旨在阐明该疾病的发展过程,提高诊断的准确性,并解决其临床表现和遗传变异问题,重点是确定导致其发病机制的新基因突变和表观遗传因素。
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Familial Mediterranean Fever in Childhood.

Familial Mediterranean fever (FMF) is the most prevalent monogenic autoinflammatory disorder, characterized by recurrent fever and serositis. It primarily affects individuals of Mediterranean descent, including Arabs, Armenians, Turks, and Jews. The Mediterranean fever (MEFV) gene, responsible for FMF, was discovered in 1997. Biallelic pathogenic variants lead to excessive activation of the pyrin inflammasome, resulting in inflammation. Clinical manifestations include recurrent fever, abdominal pain, and joint involvement, with attacks typically lasting 12-72 hours. Diagnosis relies on clinical criteria and is supported by genetic testing. Colchicine is the primary treatment to reduce attack frequency and prevent the complications like renal amyloidosis. Despite advancements in understanding FMF, including its genetic basis and treatment options, challenges remain in distinguishing it from other autoinflammatory diseases. Co-existing conditions such as juvenile idiopathic arthritis and inflammatory bowel disease are common among FMF patients. Ongoing research should aim to clarify the development of the disease, enhance diagnostic accuracy, and address its clinical presentation and genetic variability, with a focus on identifying new genetic mutations and epigenetic factors that contribute to its pathogenesis.

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