Acute stroke in familial Mediterranean fever: An analysis of 23 new cases and systematic review of the literature.

Autor: Topcuoglu MA; Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey., Ayvacioglu-Cagan C; Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey., Arsava EM; Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey., Acar-Ozen P; Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey., Kalyoncu U; Department of Internal Medicine and Rheumatology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey., Gocmen R; Department of Radiology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey., Akbaba TH; Department of Medical Biology, Faculty of Medicine, Hacettepe University, Ankara, Turkey., Balcı-Peynircioğlu B; Department of Medical Biology, Faculty of Medicine, Hacettepe University, Ankara, Turkey., Tuncer MA; Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey.
Jazyk: angličtina
Zdroj: International journal of rheumatic diseases [Int J Rheum Dis] 2023 Apr; Vol. 26 (4), pp. 657-666. Date of Electronic Publication: 2023 Feb 06.
DOI: 10.1111/1756-185X.14588
Abstrakt: Objective: The nature of neurovascular involvement in cases of familial Mediterranean fever (FMF) has not been adequately clarified.
Methods and Patients: Clinical features, infarct topography, vascular status, and stroke etiology were prospectively determined in 35 acute neurovascular events that occurred in 23 FMF patients. Clinicoradiological features were compared with an age- and gender-matched control group of 115 acute stroke patients. Characteristics of additional FMF and acute stroke cases (6 episodes in 6 patients) identified from a systematic literature review (PROSPERO registration no: CRD420212264820) were also analyzed.
Results: There were 27 acute ischemic stroke episodes in 19 patients, 7 transient ischemic attack episodes in 3 patients, and 1 patient with a single episode of parietal hematoma in our cohort. Twenty (74%) ischemic stroke episodes in 12 patients were cryptogenic. Ten of these 12 cases had a previous FMF diagnosis and were taking colchicine. There was no significant difference in the FMF group in terms of the presence of vascular risk factors and angiography-documented disease in comparison to controls. Cerebral distal artery involvement was significantly prevalent in FMF (78% vs 45%, P = .002). Especially, midbrain central deep perforating territory involvement was higher (30% vs 1%, P < .001). The long-term prognosis (median 8.5 years) under antiplatelet agents and colchicine is favorable.
Discussion: The acute stroke phenotype in FMF cases is herein described for the first time. Several clinicoradiological features such as thrombotic lacunar infarcts located in the central mesencephalon seem so typical that we recommend searching for FMF mutations in geographic regions where FMF is common.
(© 2023 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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