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Ailevi Akdeniz Ateşi ile İzlenen bir Hastada IgA Nefriti: 5 Yıllık Takip

IgA Nephritis in a Patient with Familial Mediterranean Fever: 5 Years-Follow-up

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DOI: 
DOI 10.5262/tndt.2010.1003.15

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Abstract (2. Language): 
Familial Mediterranean Fever (FMF) is an inflammatory autosomal recessive disease characterized by serosal and synovial involvement. Although secondary amyloidosis is the most common of the renal diseases observed with FMF, other glomerular involvements have also been demonstrated. Unfortunately only a few cases about IgA nephritis in patients with FMF have been reported in literature. Here we present a 56-year-old male patient who was diagnosed with chronic IgA nephritis by renal biopsy after detection of intermittent hematuria and proteinuria while he was being monitored for FMF disease. The patient was followed up for 5 years and treated with regular colchicine. Our case shows that amyloidosis is not only the type of renal involvement in patients with FMF. Kidney biopsy should be performed in patients with FMF displaying micro- or macroscopic hematuria with or without proteinuria.
Abstract (Original Language): 
Ailevi Akdeniz Ateşi (AAA) serozal ve synovial tutulumla karakterize inflamatuvar otozomal resesif bir hastalıktır. AAA ile birlikte en sık görülen böbrek tutulumu sekonder amiloidoz olmasına rağmen nadiren diğer glomerüler hastalıklarla da birliktelik tanımlanmıştır. Maalesef literatürde AAA ile IgA Nefriti nadiren bir arada tanımlanmıştır. Biz burada AAA tanısı ile izlenirken tekrarlayan hematüri ve proteinüri tespit edildikten sonra renal biyopsi yoluyla Kronik IgA Nefriti tanısı konulan 56 yaşındaki erkek hastayı sunduk. Hasta beş yıldır polikliniğimizde takip ediliyor ve düzenli kolşisin tablet kullanıyordu. Olgumuz AAA’lı hastalarda böbrek tutulumunun tek tipinin amiloidoz olmadığını göstermektedir. Proteinüri olsun ya da olmasın mikroskopik veya makroskopik hematüri tespit edilen tüm AAA’lı hastalarda böbrek biyopsisi yapılmalıdır.

REFERENCES

References: 

1. Ancient missense mutations in a new member of the RoRet gene
family are likely to cause familial Mediterranean fever: The
International FMF Consortium. Cell 1997; 90: 797– 807
2. Zaks N, Shinar Y, Padeh S, Lidar M, Mor A, Tokov I, Pras M,
Langevitz P, Pras E, Livneh A: Analysis of the three most common
MEFV mutations in 412 patients with familial Mediterranean fever.
Isr Med Assoc J 2003; 5: 585– 588
3. Livneh A, Langevitz P: Diagnostic and treatment concerns in
familial Mediterranean fever. Baillieres Best Pract Res Clin
Rheumatol 2000; 14: 477– 498
4. Kukuy OL, Kopolovic J, Blau A, Ben-David A, Lotan D, Shaked
M, Shinar Y, Dinour D, Langevitz P, Livneh A: Mutations in the
familial Mediterranean fever gene of patients with IgA nephropathy
and other forms of glomerulonephritis. Clin Genet 2008; 73:
146- 151
5. Ozen S, Ben-Chetrit E, Bakkaloglu A, Gur H, Tinaztepe K,
Calguneri M, Turgan C, Turkmen A, Akpolat I, Danaci M, Besbas
N, Akpolat T: Polyarteritis nodosa in patients with familial
Mediterranean fever (FMF): A concomitant disease or a feature of
FMF? Semin Arthritis Rheum 2001; 30: 281– 287
6. Flatau E, Kohn D, Schiller D, Lurie M, Levy E: Schonlein-Henoch
syndrome in patients with familial Mediterranean fever. Arthritis
Rheum 1982; 25: 42– 47
7. Akpolat T, Yilmaz E, Ozen S, Akpolat I, Danaci M, Kandemir B:
M680I/M694 V mutations in a patient with familial Mediterranean
fever and polyarteritis nodosa. Nephrol Dial Transplant 1998; 13:
2633– 2635
8. Shohat M, Magal N, Shohat T, Chen X, Dagan T, Mimouni A,
Danon Y, Lotan R, Ogur G, Sirin A, Schlezinger M, Halpern GJ,
Schwabe A, Kastner D, Rotter JI, Fischel-Ghodsian N: Phenotypegenotype
correlation in familial Mediterranean fever: evidence for
an association between Met 694V al and amyloidosis. Eur J Hum
Genet 1999; 3: 287- 292
9. Zemer D, Livneh A, Pras M, Sohar E: The kidney in familial
Mediterranean fever. Contrib Nephrol 1993; 102: 187– 197
10. Lee G, Glassock RJ, Ponticelli C, Glassock R: Immunoglobulin
A nephropathy. In: Ponticelli C, Glassock R, (eds). Treatment of
Primary Glomerulonephritis. Oxford: Oxford Medical Publication
1997;187–217
11. Donadio JV, Grande JP: IgA nephropathy. N Engl J Med 202;
347:738– 748
12. Rai A, Nast C, Adler S. Henoch-Schonlein purpura nephritis. J Am
Soc Nephrol 1999; 10: 2637- 2644
13. Radford MG Jr, Donadio JV Jr, Bergstralh EJ, Grande JP: Predicting
renal outcome in IgA nephropathy. J Am Soc Nephrol 1997; 8:
199- 207
Cilt/Vol: 19, No: 3, 2010, Sayfa/Page: 224-227 227
Gullu BE et al: IgA Nephritis in a Patient with Familial Mediterranean Fever:
5 Years-Follow-up
Türk N efroloji D iyaliz ve Transplantasyon D ergisi
Turkish Nephrology, Dialysis and Transplantation Journal
14. Béné MC, Faure GC: Mesangial IgA in IgA nephropathy arises
from the mucosa. Am J Kidney Dis 1988; 12: 406- 409
15. Gershoni-Baruch R, Broza Y, Brik R: Prevalence and significance
of mutations in the familial Mediterranean fever gene in Henoch
Schoenlein purpura. J Pediatr 2003; 143: 658- 661
16. Pras M, Bronshpigel N, Zemer D, Gafni J: Variable incidence of
amyloidosis in familial Mediterranean fever among different ethnic
groups. Johns Hopkins Med J 1982; 150: 22- 26
17. Tunca M, Akar S, Onen F, Ozdogan H, Kasapcopur O, Yalcinkaya
F, Tutar E, Ozen S, Topaloglu R, Yilmaz E, Arici M, Bakkaloglu
A, Besbas N, Akpolat T, Dinc A, Erken E, Turkish FMF Study
Group: Familial Mediterranean Fever (FMF) in Turkey: Results of
a Nationwide Multicenter Study. Medicine 2005; 84: 1- 11
18. Ehrenfeld EN, Eliakim M, Rachmilewitz M: Recurrent Polyserositis
(FMF; periodic disease). A report of 55 cases. Am J Med 1970; 31:
107- 123
19. Reimann HA, Moadıe J, Semerdjıan S, Sahyoun PF: Periodic
peritonitis; heredity and pathology: report of seventy-two cases. J
Am Med Assoc 1954; 154: 1254- 1259
20. Eliakim M, Rachmilewitz M, Rosenmann E, Niv A: Renal
manifestations in recurrent polyserositis (FMF). Isr J Med Sci
1970; 6: 228– 245
21. Flatau E, Kohn D, Schiller D, Lurie M, Levy E: Schönlein Henoch
syndrome in patients with familial Mediterranean fever. Arthritis
Rheum 1982; 25: 42- 47
22. Cagdas DN, Gucer S, Kale G, Duzova A, Ozen S:
Familial Mediterranean fever and mesangial proliferative
glomerulonephritis: report of a case and review of the literature.
Pediatr Nephrol 2005; 20: 1352- 1354
23. Tekin M, Yalçinkaya F, Tümer N, Cakar N, Koçak H, Ozkaya N,
Gençgönül H: Familial Mediterranean fever-renal involvement by
diseases other than amyloid. Nephrol Dial Transplant 1999; 14:
475- 479
24. Gok F, Sari E, Erdogan O, Altun D, Babacan O: Familial
Mediterranean fever and IgA nephropathy: Case report and review
of the literature. Clin Nephrol 2008; 70: 62- 64
25. Rigante D, Federico G, Ferrara P, Maggiano N, Avallone L, Pugliese
AL, Stabile A: IgA nephropathy in an Italian child with familial
Mediterranean fever. Pediatr Nephrol 2005; 20: 1642- 1644
26. Said R, Hamzeh Y, Said S, Tarawneh M, al-Khateeb M: Spectrum
of renal involvement in familial Mediterranean fever. Kidney Int
1992; 41: 414– 419

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