DOI: 10.31362/patd.1960907 ISSN: 1309-9833

Role of serum pentraxin-3 levels in the evaluation of subclinical inflammation in children with Familial Mediterranean Fever

Eşe Eda Turanlı, Selcuk Yuksel, Tülay Becerir, Havva Evrengül
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Purpose: Subclinical inflammation may persist in some patients with Familial Mediterranean Fever despite colchicine treatment. Pentraxin-3 is used as a potential biomarker of inflammatory activity in various inflammatory diseases. This study aimed to evaluate serum PTX-3 levels during attack and attack-free periods in children with Familial Mediterranean Fever and to investigate the possible association between serum PTX-3 levels and subclinical inflammation.Materials and methods: Forty-five children diagnosed with Familial Mediterranean Fever and receiving colchicine treatment and 40 healthy controls were included. Serum pentraxin-3 levels and conventional acute-phase reactants were measured during attack and attack-free periods. Patients with at least one elevated acute-phase reactant during the attack-free period were considered to have subclinical inflammation.Results: Pentraxin-3 levels and conventional acute-phase reactants were significantly higher during attack periods compared with attack-free periods and healthy controls (3.21±0.67 vs 1.90±0.15 vs 0.88±0.39 ng/mL, respectively; p<0.001). Serum pentraxin-3 levels were similar between patients with and without subclinical inflammation (1.9±0.05 vs 1.8±0.03 ng/mL; p=0.29); however, both subgroups had significantly higher pentraxin-3 levels than healthy controls (p=0.001). ROC analysis showed excellent diagnostic performance of PTX-3 for differentiating FMF patients from healthy controls, with an AUC of 1.000 (cut-off ≥1.80 ng/mL, sensitivity 100%, specificity 100%) during the attack period and 0.997 (cut-off ≥1.64 ng/mL, sensitivity 97.8%, specificity 100%) during the attack-free period.Conclusion: Pentraxin-3 levels remained elevated in children with Familial Mediterranean Fever during both attack and attack-free periods compared with healthy controls, and PTX-3 discriminated FMF patients from healthy controls with excellent diagnostic accuracy during both the attack period (AUC=1.000) and the attack-free period (AUC=0.997). These findings suggest that PTX-3 may reflect persistent inflammatory activity in pediatric FMF patients and could serve as a useful marker of disease activity beyond overt clinical episodes. Larger prospective studies are needed to confirm these findings.

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