P FMF X H PYLORI

 A

• Study Title: Effect of Helicobacter pylori on inflammatory parameters, attack frequency, and attack duration in children with Familial Mediterranean Fever (FMF)

• Author: Agin M

• Institution: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Gazi Yasargil Education and Research Hospital

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Background

• Familial Mediterranean Fever (FMF) is an autosomal recessive disorder characterized by:

  • Recurrent, self-limiting fever

  • Abdominal pain

  • Pleuritis

  • Arthritis

  • Erysipelas-like skin lesions

• Prior studies suggest clinical improvement in autoimmune/autoinflammatory conditions after eradication of Helicobacter pylori (HP).

• The relationship between HP infection and FMF attack severity/frequency remains unclear.

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Objective

• To evaluate the effect of HP infection on:

  • Inflammatory parameters (WBC, ESR, CRP, fibrinogen)

  • Attack frequency

  • Attack duration

• Study population: Children with FMF experiencing persistent abdominal pain.

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Methods

• Sample size: 49 pediatric FMF patients

• All:

  • Previously diagnosed with FMF (based on Tel-Hashomer Criteria)

  • Receiving colchicine therapy

  • Underwent endoscopy due to ongoing abdominal pain

• Gastric biopsies obtained for histopathological examination.

• Compared HP-positive patients:

  • Before and after HP eradication treatment

• Parameters analyzed:

  • Hemogram

  • Sedimentation (ESR)

  • CRP

  • Fibrinogen

  • Attack frequency

  • Attack duration

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Results

• Mean age: 12.6 ± 6 years

• Gender distribution:

  • 53% male

  • 47% female

• HP status:

  • 61% HP positive

  • 39% HP negative

• Age comparison:

  • HP (+): 11.7 ± 4.2 years

  • HP (−): 9.26 ± 5.1 years

After HP eradication (HP+ group):

• Decreases observed in:

  • White blood cell count

  • Fibrinogen

  • ESR

  • CRP

  • Attack duration

• However:

  • These decreases were not statistically significant (P > 0.05)

• Attack frequency showed a statistically significant decrease (P < 0.05)

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Conclusion

• HP eradication was associated with a significant reduction in FMF attack frequency.

• No significant change in inflammatory markers or attack duration.

• HP infection should be considered in FMF patients with frequent attacks.

• Screening for HP may be beneficial in selected FMF cases.