Evaluation of the structure, autoimmunity, and functions of the thyroid gland in familial Mediterranean fever patients

Abstract

Objective: Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder that is frequently seen in the eastern Mediterranean region. The thyroid gland can be affected in FMF patients through autoimmunity or amyloidosis. Here, we aimed to evaluate the structure and functions of the thyroid gland in addition to possible autoimmunity in FMF patients. Subjects and methods: The study was conducted by the Endocrinology and Metabolism and Internal Medicine Departments. Thirty FMF patients and 30 age and gender-matched healthy controls were enrolled in the study. Free thyroxin (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) autoantibodies were investigated. Detailed thyroid grayscale and Doppler Ultrasonography examinations and shear-wave elastosonography (SWE) were performed in the patient and control groups. Results: Anti-TPO was detected in 24% (n = 7) of the patients. On the grayscale US, mean thyroid volumes were similar between the FMF and the control groups (p > 0.05). By Doppler US, thyroid vascularity observed was detected in 10.3% (n = 3) of the patients. SWE revealed that the mean velocity value of right vs. left lobe in the patient group was 1.77 ± 0.45 m/s and 1.95 ± 0.51 m/s, respectively. Compared to the control group, the mean velocity values were significantly higher in the right (p = 0.004) and left (p = 0.01) lobes of the patient group. The mean stiffness value in the patient group was also significantly higher in the right and left lobes [10.13 ± 5.65 kPa (p = 0.005) and 12.24 ± 6.17 kPa (p = 0.02), respectively]. Conclusion: Recognizing the complications of FMF early in the course of the disease is as important as the early diagnosis of the disorder. Based on this, thyroid functions and changes in its structure should be evaluated carefully for early diagnosis of a possible coexisting thyroid disorder.

Indirect evaluation of amyloid deposition by ultrasonography and its relationship with MEFV gene mutation in FMF patients

“…Thyroid parenchyma stiffness increased in FMF patients compared to the control group; however, its relation to FMF duration from the first attack was not found in our study. Analogously no correlation was found between the duration of FMF disease and thyroid gland SWE findings in the study of Yılmaz et al 1 A relation was detected between the duration of disease and only inferior thyroidal artery RI in our study. We think that this situation can be explained by other main factors such as the limited number of patients or MEFV mutation type independent of FMF duration for amyloidosis deposition in our study.…”

“…Thyroid gland involvement in FMF patients may be through increasing autoimmune disease incidence or amyloidosis deposition 1 . Amyloidosis deposition in the thyroid gland was reported in 30%–80% of the patients with primary and secondary amyloidosis 18 .…”

“…13,17 Thyroid gland involvement in FMF patients may be through increasing autoimmune disease incidence or amyloidosis deposition. 1 Amyloidosis deposition in the thyroid gland was reported in 30%-80% of the patients with primary and secondary amyloidosis. 18 Thyroid parenchyma stiffness increased in FMF patients compared to the control group; however, its relation to FMF duration from the first attack was not found in our study.…”

“…One of the most significant causes of amyloidosis is especially Familial Mediterranean Fever (FMF), which is observed in Mediterranean countries. FMF is a disease characterized by repeating attacks influencing many systems in the body that is frequently accompanied by fever 1 . FMF gene, which is called Mediterranean fever ( MEFV ), is present in the p13.3 region of the 16th chromosome and the most frequently seen autoinflammatory disease 2 .…”