Related Experiment Video
Updated: Jun 27, 2026
A Reproducible Computerized Method for Quantitation of Capillary Density using Nailfold Capillaroscopy
Published on: October 27, 2015
Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever
Ahmed S Abo Hola1, Rania S El Zayat2, Wafaa Ahmed Shehata3
1Department of Pediatrics, Faculty of Medicine, Menoufia University, Yassin Abdel-Ghafar Street, Shebin El-Kom, Shebin El-Kom, 32511, Menoufia, Egypt. dr.ahmadped@yahoo.com.
Insights
Children with Familial Mediterranean Fever (FMF) show enduring insulin resistance, abnormal lipid profiles, and nailfold capillary changes, indicating heightened cardiovascular risk. Monitoring these markers is vital for early intervention in pediatric FMF patients.
Area of Science:
- Pediatric Rheumatology
- Cardiovascular Risk Assessment
- Vascular Biology
Background:
- Familial Mediterranean Fever (FMF) is a chronic inflammatory disorder associated with increased cardiovascular risk, particularly in children.
- Limited data exists on cardiovascular risk factors and vascular changes in pediatric FMF patients.
- Nailfold capillaroscopy (NC) is increasingly used to evaluate peripheral vascular disease in inflammatory conditions.
Purpose of the Study:
- To evaluate insulin resistance, lipid profiles, atherogenic indices, and nailfold capillary (NC) changes in children with FMF.
- To compare these parameters between FMF patients and controls, and during acute attacks versus attack-free periods.
- To explore correlations between metabolic parameters, NC changes, and disease characteristics.
Main Methods:
- Fifty-four children with FMF underwent assessments including complete blood count, inflammatory markers (ESR, CRP, SAA), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), lipid profiles, and atherogenic indices.
- Nailfold capillaroscopic examinations were performed during both acute attacks and attack-free periods.
- Data were compared to controls, and correlations were analyzed.
Main Results:
- FMF patients exhibited elevated inflammatory markers, HOMA-IR, total cholesterol, non-HDL-C, and atherogenic indices, with lower hemoglobin during attack-free periods compared to controls.
- NC examination revealed avascular areas, tortuosities, enlargements, and microhemorrhages in a significant proportion of patients.
- These parameters worsened during acute attacks, with HOMA-IR correlating positively with lipid parameters and NC changes correlating with disease duration and SAA levels.
Conclusions:
- Children with FMF experience persistent insulin resistance, dyslipidemia, and nailfold capillary abnormalities, even during attack-free periods, with exacerbation during acute phases.
- These findings suggest subclinical vascular injury and an elevated cardiovascular risk profile in pediatric FMF.
- Regular monitoring of these parameters is crucial for timely detection and management of cardiovascular complications in children with FMF.
Background:
There's an increasing role of nailfold capillaroscopy in the evaluation of peripheral vascular disease in chronic inflammatory disorders. Familial Mediterranean fever (FMF) is one such disorder, which raises concerns about increased cardiovascular risk, with scarce data available in children. Therefore, we aimed to evaluate insulin resistance, lipid profile, atherogenic indices, and nailfold capillary (NC) changes in children with FMF.
Methods:
Fifty-four children diagnosed with FMF were evaluated by measuring complete blood count, ESR, CRP, serum amyloid A (SAA), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), lipid profile, and atherogenic indices, along with a nailfold capillaroscopic examination, both during acute attacks and attack-free periods.
Results:
During attack-free periods, patients exhibited higher total leucocytic counts, ESR, CRP, SAA, HOMA-IR, total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), Castelli's risk index I (CRI I), and atherogenic coefficient (AC), and a lower hemoglobin level than controls. Additionally, the NC examination identified avascular areas in 14.8% of patients, tortuosities in 18.5%, enlargements in 14.8%, and microhemorrhages in 7.4%. These parameters showed significant increases during acute attacks. HOMA-IR showed positive correlations with TC, non-HDL-C, CRI I, and AC; however, NC changes were strongly connected with disease duration and SAA.
Conclusions:
Insulin resistance, alterations in serum lipids and atherogenic indices, and NC changes significantly endure in children with FMF during attack-free periods compared to controls, with more prominence during acute attacks. These parameters are linked to subclinical vascular injury and elevated cardiovascular risk, so their monitoring is crucial in these patients for early detection and intervention.
More Related Videos
09:40Phosphorus-31 Magnetic Resonance Spectroscopy: A Tool for Measuring In Vivo Mitochondrial Oxidative Phosphorylation Capacity in Human Skeletal Muscle
Published on: January 19, 2017
05:06Non-Invasive Visualization of Nailbed Microvascular Morphology in Mice Using Capillaroscopy
Published on: February 28, 2025
Related Concept Videos
01:20Inborn Errors of Metabolism
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:26Nephrotic Syndrome II : Assessment and Medical Management