Relationship of serum vitamin D, D-dimer and uric acid levels with attacks in children with familial Mediterranean fever

Aim of the work: Familial Mediterranean fever (FMF) is the most common autoinflammatory disease that progresses with attacks of fever and serosal or skin inflammation. The first attacks typically begin during childhood and last for 12-72 h. The aim of this study was to determine the relationship of the serum 25hydroxyvitamin D3(25(OH)D), D-dimer, and uric acid levels with attacks and subclinical inflammation in children with FMF. Patients and methods: A total of 178 patients with FMF recruited from the pediatric nephrology clinic were studied. Patients' characteristics, serum 25(OH) D, D-dimer, uric acid levels and other laboratory findings were obtained from patient files and/or hospital system records. Results: The age of the patients was 10.71 +/- 3.94 (2.5-18) years, age at onset 8.7 +/- 3.5 years and they were 95 females and 83 males (F:M 1.14:1). 38 had attacks. Symptoms during the attacks included fever in all children, abdominal pain in 93.3%, arthralgia in 75.8% and headache in 2.2%. The mean vitamin D level was 21.81 +/- 11.97 ng/ml, median D-dimer 408.03 (111-3770) ng/ml and serum uric acid was 4.04 +/- 1. 27 mg/dl. Hypovitaminosis D was present in 86.5%. White blood cell count, C-reactive protein level, erythrocyte sedimentation rate, serum amyloid A, uric acid and D-dimer levels were higher in patients during attacks compared to those during attack-free periods (p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.022, and p = 0.001, respectively). Conclusions: Hypovitaminosis D is frequent in FMF children and thus vitamin D supplementation is warranted. D-dimer and uric acid levels may be used as markers during follow-up of attacks. (c) 2022 Egyptian Society of Rheumatic Diseases. Publishing services provided by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).