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Adrenal axis functions in patients with familial Mediterranean fever

Tansu Sav1, Sav Tansu, Omer Ozbakir

  • 1Department of Nephrology, Erciyes University, Kayseri, Turkey. tsav@erciyes.edu.tr

Clinical Rheumatology
|November 4, 2005
PubMed
Abstract

Insights

Familial Mediterranean Fever (FMF) patients show increased hypothalamic-pituitary-adrenal (HPA) axis activation during attacks, indicated by higher cortisol levels. This suggests inflammatory cytokines may stimulate the HPA axis in FMF.

Area of Science:

  • Endocrinology
  • Immunology
  • Genetics

Background:

  • Familial Mediterranean Fever (FMF) is an inherited autoinflammatory disorder.
  • The impact of FMF on the endocrine system, particularly the hypothalamic-pituitary-adrenal (HPA) axis, is not well understood.
  • Cytokines like IL-1, IL-6, and TNF-alpha are known activators of the HPA axis.

Purpose of the Study:

  • To investigate the function of the HPA axis in FMF patients without amyloidosis.
  • To determine if FMF attacks influence HPA axis activity.

Main Methods:

  • Twenty-one FMF patients were enrolled in the study.
  • An adrenocorticotropic hormone (ACTH) stimulation test was administered to assess HPA axis response.
  • The ACTH stimulation test was performed during both the attack and remission periods in FMF patients.

Main Results:

  • Peak cortisol levels were significantly higher during FMF attacks compared to remission periods (p<0.05).
  • The HPA axis demonstrated a more pronounced activation during FMF attacks.

Conclusions:

  • The HPA axis is more activated during FMF attacks, likely due to stimulation by inflammatory cytokines.
  • Adrenal hormone levels may increase during acute inflammatory events in FMF, correlating with cytokine levels.
  • The HPA axis appears to be regulated normally in FMF patients, despite heightened activation during attacks.

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