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Role of serum calprotectin in identifying familial Mediterranean fever attacks
Merve Gokcen Polat1, Ahmet Omma2, Neslihan Gokcen3
1Department of Internal Medicine, Ankara Bilkent City Hospital, Ankara, Turkey. drgokcenpolat@gmail.com.
Background/Aim:
The aim of the study was to evaluate serum calprotectin (CLP) levels in familial Mediterranean fever (FMF) patients and to investigate the utility of CLP in distinguishing patients with attack from patients without attack.
Material And Method:
FMF patients, rheumatoid arthritis (RA) patients, and healthy controls were included. Serum calprotectin levels were quantified utilizing the enzyme-linked immunosorbent assay (ELISA) method. Receiver operating characteristic (ROC) curve analysis was used to identify the cut-off value of serum CLP level to differentiate FMF patients with attack from those without. Logistic regression analysis was performed to identify predictors.
Results:
Significant differences were observed among the three groups concerning white blood cell (WBC), neutrophil, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum CLP levels (p = 0.003, p = 0.004, p < 0.001, p < 0.001, and p = 0.002, respectively). Higher ESR, CRP, and serum CLP levels were observed in FMF patients with attacks than those without (all, p < 0.001). Serum CLP was significantly higher in RA patients than in FMF patients in remission (p < 0.001). ROC analysis identified a threshold CLP concentration in FMF with an attack to be 47.1 pg/mL (83.3% sensitivity, 60.6% specificity, AUC = 0.74, 95% CI = 0.63-0.85, p < 0.001). In univariate logistic regression analysis, CLP (β = 1.045, 95% CI = 1.017-1.073, p = 0.001) was predictive of FMF patients experiencing an attack.
Conclusion:
Serum CLP proves to be as productive as ESR in illustrating inflammation and demonstrating the existence of attacks in FMF patients.
Insights
Serum calprotectin (CLP) effectively indicates inflammation in familial Mediterranean fever (FMF) patients. Elevated CLP levels help distinguish FMF patients experiencing an attack from those without, similar to erythrocyte sedimentation rate (ESR).
Area of Science:
- Rheumatology
- Immunology
- Clinical Chemistry
Background:
- Familial Mediterranean fever (FMF) is a genetic autoinflammatory disorder.
- Distinguishing FMF attacks from other inflammatory states is clinically important.
- Serum calprotectin (CLP) is an emerging inflammatory marker.
Purpose of the Study:
- To evaluate serum calprotectin (CLP) levels in familial Mediterranean fever (FMF) patients.
- To assess the utility of CLP in differentiating FMF patients during an attack versus remission.
- To compare CLP levels with other inflammatory markers like ESR and C-reactive protein (CRP).
Main Methods:
- Serum CLP levels were measured using enzyme-linked immunosorbent assay (ELISA).
- Study included FMF patients, rheumatoid arthritis (RA) patients, and healthy controls.
- Receiver operating characteristic (ROC) curve and logistic regression analyses were employed.
Main Results:
- Serum CLP levels were significantly different across FMF, RA, and control groups.
- FMF patients with attacks showed higher ESR, CRP, and serum CLP compared to those without attacks.
- A serum CLP cut-off of 47.1 pg/mL demonstrated 83.3% sensitivity and 60.6% specificity for FMF attacks.
Conclusions:
- Serum calprotectin is a valuable biomarker for inflammation in FMF.
- CLP levels can effectively indicate the presence of FMF attacks.
- Serum CLP demonstrates comparable utility to ESR in illustrating inflammation and FMF attacks.
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