TY  - JOUR
TI  - Appendectomy history is associated with severe disease and colchicine resistance in adult familial Mediterranean fever patients
AB  - Background/aim: Peritonitis attacks of Familial Mediterranean Fever (FMF) usually requires emergency medical admissions and it’s hard to distinguish a typical abdominal attack from surgical causes of acute abdomen. Therefore, history of abdominal surgery, particularly appendectomy, is very common in patients with FMF. However, history of appendectomy might also give some clues about the course of FMF in the adulthood. This study was to determine whether the history of appendectomy help to anticipate disease course of FMF in the adulthood. Materials and methods: All patients recruited from FMF in Central Anatolia (FiCA) cohort, comprising 971 adult subjects. All patients fulfilled the Tel Hashomer criteria. Demographic data, FMF disease characteristics, co-morbid conditions, past medical history, surgical history and disease complications were meticulously questioned and laboratory features and genotype data (if available) were recruited from patient files. Results: Appendectomy history was evident in 240 (24.7%) subjects. Disease onset was earlier and peritonitis is strikingly more prevalent (97.1% vs. 89.6%, p < 0.001) in appendectomized patients. These patients had reported almost two fold more frequent attacks in the last year compared to appendix intact patients (median 3.5 vs. 2 attacks, p = 0.001) without a difference in frequency of musculoskeletal and skin attacks. Severe disease was more common (10% vs. 5.9%, p = 0.038) due to involvement of more attack sites throughout the life and more frequent attacks. Appendectomy patients had used higher daily doses of colchicine to control disease (1.43 ± 0.6 mg vs. 1.27 ± 0.52 mg, p = 0.002) but colchicine resistance was also more common in these patients, 15% vs. 6.7% respectively, p < 0.001. Conclusion: Appendectomy history is common in FMF patients and associated with frequent serositis attacks in adulthood. These patients require higher colchicine doses with a lower rate of response and more need for Interleukin-1 antagonist therapies.Key words: Familial Mediterranean fever, appendectomy, surgery, prognosis, colchicine resistance
AU  - Satış, Hasan
AU  - öztürk, mehmet akif
AU  - Atas, Nuh
AU  - Bilici Salman, Reyhan
AU  - TUFAN, ABDURRAHMAN
AU  - Goker, Berna
AU  - Armagan, Berkan
AU  - SARI, ALPER
AU  - Yardimci, Gozde Kubra
AU  - Kılıç, Levent
AU  - Kalyoncu, Umut
AU  - KASIFOGLU, TIMUCIN
AU  - Yasar Bilge, Nazife Sule
AU  - HAZNEDAROGLU, SEMINUR
AU  - BODAKÇİ, ERDAL
AU  - Babaoglu, Hakan
DO  - 10.3906/sag-2011-74
PY  - 2021
JO  - Turkish Journal of Medical Sciences
VL  - 51
IS  - 4
SN  - 1300-0144
SP  - 1706
EP  - 1711
DB  - TRDizin
UR  - http://search/yayin/detay/480152
ER  -