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

Objective The most significant complication in familial mediterranean fever (FMF) patients is dysfunction and organ failure developing depending on amyloid deposition in organs. The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave ela...

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Published in:Journal of clinical ultrasound 2023-05, Vol.51 (4), p.715-722
Main Authors: Urfali, Mine, Yilmaz, Gürkan, Özkul, Bahattin, Urfali, Furkan Ertürk
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Yilmaz, Gürkan
Özkul, Bahattin
Urfali, Furkan Ertürk
description Objective The most significant complication in familial mediterranean fever (FMF) patients is dysfunction and organ failure developing depending on amyloid deposition in organs. The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave elastography as a non‐invasive method in a restricted number of studies conducted, and it is considered that amyloid deposition can be shown indirectly. In our study, we aimed to indirectly evaluate amyloid deposition in organs with Shear wave and Doppler ultrasonography and to reveal its relationship with MEFV gene mutation analysis. Method 42 FMF patients with normal thyroid and renal function tests and 35 participants with no FMF symptoms were included in our study. FMF patients were grouped depending on their MEFV mutation analyses. Thyroid, salivary glands, and renal parenchymal tissue stiffness were evaluated by shear wave elastography. Thyroidal artery and both renal artery resistances were evaluated by Doppler ultrasonography. Results Both parotis gland, thyroid and renal parenchymal stiffness and arterial vascular resistances in the patient group were found higher than the control group. A significant difference was not found in any parameters in classification based on gender. Tissue stiffness and vascular resistance values in the patient group with M694V homozygote mutation were found statistically significantly higher than the other mutation groups (p 
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The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave elastography as a non‐invasive method in a restricted number of studies conducted, and it is considered that amyloid deposition can be shown indirectly. In our study, we aimed to indirectly evaluate amyloid deposition in organs with Shear wave and Doppler ultrasonography and to reveal its relationship with MEFV gene mutation analysis. Method 42 FMF patients with normal thyroid and renal function tests and 35 participants with no FMF symptoms were included in our study. FMF patients were grouped depending on their MEFV mutation analyses. Thyroid, salivary glands, and renal parenchymal tissue stiffness were evaluated by shear wave elastography. Thyroidal artery and both renal artery resistances were evaluated by Doppler ultrasonography. Results Both parotis gland, thyroid and renal parenchymal stiffness and arterial vascular resistances in the patient group were found higher than the control group. A significant difference was not found in any parameters in classification based on gender. Tissue stiffness and vascular resistance values in the patient group with M694V homozygote mutation were found statistically significantly higher than the other mutation groups (p &lt; 0.001). Conclusion Our study shows that identifying genetic mutation type in FMF patients will help determine possibly amyloidosis risk. Imaging of tissue stiffness by shear wave elastography and evaluation of vascular resistance by Doppler can be useful for routine screening of those patients. Increased AA amyloid in the blood during FMF attacks impairs tissue functions and increases tissue stiffness. Tissue stiffness and increased vascular resistance due to tissue stiffness can be evaluated with ultrasound.</description><identifier>ISSN: 0091-2751</identifier><identifier>EISSN: 1097-0096</identifier><identifier>DOI: 10.1002/jcu.23409</identifier><identifier>PMID: 36449313</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>ami̇loi̇dosi̇s ; Amyloidosis ; Amyloidosis - complications ; Amyloidosis - diagnostic imaging ; Amyloidosis - genetics ; Biopsy ; Deposition ; Doppler effect ; elastography ; Evaluation ; Familial Mediterranean fever ; Familial Mediterranean Fever - complications ; Familial Mediterranean Fever - diagnostic imaging ; Familial Mediterranean Fever - genetics ; Humans ; MEFV gene ; Mutation ; Organs ; Patients ; Point mutation ; Pyrin - genetics ; Pyrin protein ; Renal artery ; Renal function ; Salivary gland ; Salivary glands ; Shear ; Stiffness ; Thyroid ; Thyroid gland ; Tissues ; Ultrasonic imaging ; Ultrasonography - adverse effects</subject><ispartof>Journal of clinical ultrasound, 2023-05, Vol.51 (4), p.715-722</ispartof><rights>2022 Wiley Periodicals LLC.</rights><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3139-85c3025a844322d349f9c6029d6cf8bc290d89cb4b993c827a1d2a042d3305593</cites><orcidid>0000-0002-9232-2220 ; 0000-0002-4875-7761 ; 0000-0002-5472-2530 ; 0000-0003-3339-8329</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36449313$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Urfali, Mine</creatorcontrib><creatorcontrib>Yilmaz, Gürkan</creatorcontrib><creatorcontrib>Özkul, Bahattin</creatorcontrib><creatorcontrib>Urfali, Furkan Ertürk</creatorcontrib><title>Indirect evaluation of amyloid deposition by ultrasonography and its relationship with MEFV gene mutation in FMF patients</title><title>Journal of clinical ultrasound</title><addtitle>J Clin Ultrasound</addtitle><description>Objective The most significant complication in familial mediterranean fever (FMF) patients is dysfunction and organ failure developing depending on amyloid deposition in organs. The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave elastography as a non‐invasive method in a restricted number of studies conducted, and it is considered that amyloid deposition can be shown indirectly. In our study, we aimed to indirectly evaluate amyloid deposition in organs with Shear wave and Doppler ultrasonography and to reveal its relationship with MEFV gene mutation analysis. Method 42 FMF patients with normal thyroid and renal function tests and 35 participants with no FMF symptoms were included in our study. FMF patients were grouped depending on their MEFV mutation analyses. Thyroid, salivary glands, and renal parenchymal tissue stiffness were evaluated by shear wave elastography. Thyroidal artery and both renal artery resistances were evaluated by Doppler ultrasonography. Results Both parotis gland, thyroid and renal parenchymal stiffness and arterial vascular resistances in the patient group were found higher than the control group. A significant difference was not found in any parameters in classification based on gender. Tissue stiffness and vascular resistance values in the patient group with M694V homozygote mutation were found statistically significantly higher than the other mutation groups (p &lt; 0.001). Conclusion Our study shows that identifying genetic mutation type in FMF patients will help determine possibly amyloidosis risk. Imaging of tissue stiffness by shear wave elastography and evaluation of vascular resistance by Doppler can be useful for routine screening of those patients. Increased AA amyloid in the blood during FMF attacks impairs tissue functions and increases tissue stiffness. Tissue stiffness and increased vascular resistance due to tissue stiffness can be evaluated with ultrasound.</description><subject>ami̇loi̇dosi̇s</subject><subject>Amyloidosis</subject><subject>Amyloidosis - complications</subject><subject>Amyloidosis - diagnostic imaging</subject><subject>Amyloidosis - genetics</subject><subject>Biopsy</subject><subject>Deposition</subject><subject>Doppler effect</subject><subject>elastography</subject><subject>Evaluation</subject><subject>Familial Mediterranean fever</subject><subject>Familial Mediterranean Fever - complications</subject><subject>Familial Mediterranean Fever - diagnostic imaging</subject><subject>Familial Mediterranean Fever - genetics</subject><subject>Humans</subject><subject>MEFV gene</subject><subject>Mutation</subject><subject>Organs</subject><subject>Patients</subject><subject>Point mutation</subject><subject>Pyrin - genetics</subject><subject>Pyrin protein</subject><subject>Renal artery</subject><subject>Renal function</subject><subject>Salivary gland</subject><subject>Salivary glands</subject><subject>Shear</subject><subject>Stiffness</subject><subject>Thyroid</subject><subject>Thyroid gland</subject><subject>Tissues</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography - adverse effects</subject><issn>0091-2751</issn><issn>1097-0096</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp1kU1v1DAQhi0EokvhwB9AlrjAIe34K4mPaNWFVq16ablaju10vUriYCet8u8xm8IBqadXM3rm0UgvQh8JnBEAen4w8xllHOQrtCEgqwJAlq_RJgcpaCXICXqX0gEASiHEW3TCSs4lI2yDlsvB-ujMhN2j7mY9-TDg0GLdL13wFls3huSP22bBczdFncIQHqIe9wvWg8V-Sji67niZ9n7ET37a45uL3U_84AaH-3larX7Au5sdHvPkhim9R29a3SX34TlP0f3u4m77o7i-_X65_XZdmPygLGphGFCha84ZpZZx2UpTApW2NG3dGCrB1tI0vJGSmZpWmliqgWeUgRCSnaIvq3eM4dfs0qR6n4zrOj24MCdFK84EiBrKjH7-Dz2EOQ75O0VrqGouq4pk6utKmRhSiq5VY_S9josioP70oXIf6thHZj89G-emd_Yf-beADJyvwJPv3PKySV1t71flb-T8lDo</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Urfali, Mine</creator><creator>Yilmaz, Gürkan</creator><creator>Özkul, Bahattin</creator><creator>Urfali, Furkan Ertürk</creator><general>John Wiley &amp; Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9232-2220</orcidid><orcidid>https://orcid.org/0000-0002-4875-7761</orcidid><orcidid>https://orcid.org/0000-0002-5472-2530</orcidid><orcidid>https://orcid.org/0000-0003-3339-8329</orcidid></search><sort><creationdate>202305</creationdate><title>Indirect evaluation of amyloid deposition by ultrasonography and its relationship with MEFV gene mutation in FMF patients</title><author>Urfali, Mine ; Yilmaz, Gürkan ; Özkul, Bahattin ; Urfali, Furkan Ertürk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3139-85c3025a844322d349f9c6029d6cf8bc290d89cb4b993c827a1d2a042d3305593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>ami̇loi̇dosi̇s</topic><topic>Amyloidosis</topic><topic>Amyloidosis - complications</topic><topic>Amyloidosis - diagnostic imaging</topic><topic>Amyloidosis - genetics</topic><topic>Biopsy</topic><topic>Deposition</topic><topic>Doppler effect</topic><topic>elastography</topic><topic>Evaluation</topic><topic>Familial Mediterranean fever</topic><topic>Familial Mediterranean Fever - complications</topic><topic>Familial Mediterranean Fever - diagnostic imaging</topic><topic>Familial Mediterranean Fever - genetics</topic><topic>Humans</topic><topic>MEFV gene</topic><topic>Mutation</topic><topic>Organs</topic><topic>Patients</topic><topic>Point mutation</topic><topic>Pyrin - genetics</topic><topic>Pyrin protein</topic><topic>Renal artery</topic><topic>Renal function</topic><topic>Salivary gland</topic><topic>Salivary glands</topic><topic>Shear</topic><topic>Stiffness</topic><topic>Thyroid</topic><topic>Thyroid gland</topic><topic>Tissues</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Urfali, Mine</creatorcontrib><creatorcontrib>Yilmaz, Gürkan</creatorcontrib><creatorcontrib>Özkul, Bahattin</creatorcontrib><creatorcontrib>Urfali, Furkan Ertürk</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical ultrasound</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Urfali, Mine</au><au>Yilmaz, Gürkan</au><au>Özkul, Bahattin</au><au>Urfali, Furkan Ertürk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Indirect evaluation of amyloid deposition by ultrasonography and its relationship with MEFV gene mutation in FMF patients</atitle><jtitle>Journal of clinical ultrasound</jtitle><addtitle>J Clin Ultrasound</addtitle><date>2023-05</date><risdate>2023</risdate><volume>51</volume><issue>4</issue><spage>715</spage><epage>722</epage><pages>715-722</pages><issn>0091-2751</issn><eissn>1097-0096</eissn><abstract>Objective The most significant complication in familial mediterranean fever (FMF) patients is dysfunction and organ failure developing depending on amyloid deposition in organs. The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave elastography as a non‐invasive method in a restricted number of studies conducted, and it is considered that amyloid deposition can be shown indirectly. In our study, we aimed to indirectly evaluate amyloid deposition in organs with Shear wave and Doppler ultrasonography and to reveal its relationship with MEFV gene mutation analysis. Method 42 FMF patients with normal thyroid and renal function tests and 35 participants with no FMF symptoms were included in our study. FMF patients were grouped depending on their MEFV mutation analyses. Thyroid, salivary glands, and renal parenchymal tissue stiffness were evaluated by shear wave elastography. Thyroidal artery and both renal artery resistances were evaluated by Doppler ultrasonography. Results Both parotis gland, thyroid and renal parenchymal stiffness and arterial vascular resistances in the patient group were found higher than the control group. A significant difference was not found in any parameters in classification based on gender. Tissue stiffness and vascular resistance values in the patient group with M694V homozygote mutation were found statistically significantly higher than the other mutation groups (p &lt; 0.001). Conclusion Our study shows that identifying genetic mutation type in FMF patients will help determine possibly amyloidosis risk. Imaging of tissue stiffness by shear wave elastography and evaluation of vascular resistance by Doppler can be useful for routine screening of those patients. Increased AA amyloid in the blood during FMF attacks impairs tissue functions and increases tissue stiffness. Tissue stiffness and increased vascular resistance due to tissue stiffness can be evaluated with ultrasound.</abstract><cop>Hoboken, USA</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>36449313</pmid><doi>10.1002/jcu.23409</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9232-2220</orcidid><orcidid>https://orcid.org/0000-0002-4875-7761</orcidid><orcidid>https://orcid.org/0000-0002-5472-2530</orcidid><orcidid>https://orcid.org/0000-0003-3339-8329</orcidid></addata></record>
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subjects ami̇loi̇dosi̇s
Amyloidosis
Amyloidosis - complications
Amyloidosis - diagnostic imaging
Amyloidosis - genetics
Biopsy
Deposition
Doppler effect
elastography
Evaluation
Familial Mediterranean fever
Familial Mediterranean Fever - complications
Familial Mediterranean Fever - diagnostic imaging
Familial Mediterranean Fever - genetics
Humans
MEFV gene
Mutation
Organs
Patients
Point mutation
Pyrin - genetics
Pyrin protein
Renal artery
Renal function
Salivary gland
Salivary glands
Shear
Stiffness
Thyroid
Thyroid gland
Tissues
Ultrasonic imaging
Ultrasonography - adverse effects
title Indirect evaluation of amyloid deposition by ultrasonography and its relationship with MEFV gene mutation in FMF patients
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