Serum resistin levels in pediatric familial Mediterranean fever: Potential biomarker for inflammatory activity

Abstract

BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis. Resistin, a pro-inflammatory cytokine, may play a role in FMF pathogenesis by promoting the release of interleukin-1beta, tumour necrosis factor alpha, and interleukin-6. AIM: To evaluate serum resistin levels in children with FMF during acute attacks and remission, and to assess its potential as a biomarker for disease activity and progression. METHODS: A case-control study was conducted involving 40 pediatric patients with FMF and 40 age- and sex-matched healthy controls. Serum resistin and inflammatory markers-including total leukocyte count (TLC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen-were measured using enzyme-linked immunosorbent assay and standard assays. RESULTS: No significant differences were found in age or sex between FMF patients and controls. Among FMF patients, fever was the most prevalent symptom (95%), followed by abdominal pain (75%). The most frequently detected genetic mutation was M694I, followed by M694V, E148Q, M680I, and V726A. Compound heterozygous mutations, including M694I/V726A and M694I/M694V, were equally represented. During acute attacks, FMF patients exhibited significantly elevated levels of TLC, ESR, CRP, SAA, and fibrinogen compared to attack-free periods and controls. Serum resistin levels were markedly higher during acute attacks and showed a strong positive correlation with other acute inflammatory markers. Receiver operating characteristic curve analysis demonstrated high sensitivity and specificity of resistin as a potential biomarker for FMF. CONCLUSION: Resistin is significantly elevated in children with FMF during acute episodes and correlates with established inflammatory markers. These findings support its potential role as a non-invasive biomarker for disease activity and severity in pediatric FMF.