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Clin Biochem. 2017 Mar;50(4-5):206-209. doi: 10.1016/j.clinbiochem.2016.11.008. Epub 2016 Nov 10.

Concordance between CRP and SAA in familial Mediterranean fever during attack-free period: A study of 218 patients.

Author information

1
Assistance publique-hôpitaux de Paris, hôpital Tenon, Centre de référence adulte de la fièvre méditerranéenne familiale, service de médecine interne, F-75020 Paris, France; Sorbonne Universités, UPMC Université Paris 06, Département hospitalo-universitaire I2B, F-75013 Paris, France. Electronic address: katia.stankovic@aphp.fr.
2
Centre hospitalier de Versailles, centre de référence des maladies autoinflammatoires rares de l'enfant (CeRéMAI), service de pédiatrie, F-78150 Le Chesnay, France.
3
Sorbonne Universités, UPMC Université Paris 06, Département hospitalo-universitaire I2B, F-75013 Paris, France; Assistance publique-hôpitaux de Paris, hôpital Tenon, UF Bio-marqueurs inflammatoires et métaboliques, Service de biochimie, F-75020 Paris, France.
4
Assistance publique-hôpitaux de Paris, hôpital Tenon, Centre de référence adulte de la fièvre méditerranéenne familiale, service de médecine interne, F-75020 Paris, France; Sorbonne Universités, UPMC Université Paris 06, Département hospitalo-universitaire I2B, F-75013 Paris, France; Sorbonne Université, UPMC université Paris 06, INSERM UMR_S933, F-75012 Paris, France.
5
Sorbonne Universités, UPMC Université Paris 06, Département hospitalo-universitaire I2B, F-75013 Paris, France; Sorbonne Université, UPMC université Paris 06, INSERM UMR_S933, F-75012 Paris, France; Assistance publique-hôpitaux de Paris, hôpital Armand-Trousseau, Centre de référence adulte de la fièvre méditerranéenne familiale, Laboratoire de génétique, F-75012 Paris, France.
6
Assistance publique-hôpitaux de Paris, hôpital Tenon, Centre de référence adulte de la fièvre méditerranéenne familiale, service de médecine interne, F-75020 Paris, France; Sorbonne Universités, UPMC Université Paris 06, Département hospitalo-universitaire I2B, F-75013 Paris, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, LIMICS, F-75005 Paris, France.

Abstract

INTRODUCTION:

Monitoring SAA level in attack-free FMF patients is recommended in order to adjust colchicine dose, and minimize the risk of AA amyloidosis. In countries where this test is not available, C-reactive protein (CRP), another acute phase reactant, is used instead. However, CRP is low and SAA is increased in some patients and vice versa.

OBJECTIVES:

To determine the threshold of CRP corresponding to SAA<10mg/L in patients with FMF and to assess their concordance at the patient level.

PATIENTS AND METHODS:

Consecutive FMF patients in attack-free period and no other cause of intermittent inflammation including infections were recruited during their regular visits in the French reference center for FMF. Demographic and genetic data were recorded; CRP and SAA were tested simultaneously. The threshold value of CRP corresponding to 10mg/L for SAA was determined and the concordance between the two markers was assessed with Cohen's kappa index.

RESULTS:

399 samples were obtained from 218 patients, mean age of 27years (33% under 18years old), 55% of female, from Sephardic Jewish origin in 71%. MEFV mutation was M694V homozygous or compound heterozygous in 52%, and simple heterozygous in 18%. Six patients had AA amyloidosis. The appropriate CRP threshold was found to be 5mg/L in children and 8.75mg/L in adults. Global agreement with SAA<10mg/L was 84% [95% confidence interval: 82 to 86%], leading to a kappa index at 0.62 [95% confidence interval: 0.57 to 0.68].

CONCLUSION:

CRP<5mg/L in FMF children or 8.75mg/L in FMF adults during attack-free periods might be a convenient substitute to guide therapeutic decisions when SAA is unavailable.

KEYWORDS:

C reactive protein; Familial Mediterranean fever; Serum amyloid A

[Indexed for MEDLINE]

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