Background The clinical and laboratory parameters widely used are not specific to discriminate the abdominal pain due to FMF attack from that of acute appendicitis.
Objectives The present study aims to investigate the urinary beta-2 microglobulin (U-β2M) level as a potential parameter to identify these two diseases mimicking each other.
Methods A total of 51 patients with established FMF diagnosis due to Tel Hashomer criteria on colchicine treatment (1–1.5mg/day), 15 patients with acute appendicitis who had appropriate clinical picture and were also supported pathologically after the surgery, and 20 healthy controls were enrolled in the study. Of the 51 patients with FMF, 25 were at an attack period, while remaining 26 were not. For the diagnosis of acute attack, as well as physical examination, laboratory tests including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were performed. From urine specimens urinary Beta-2 Microglobulin, microalbumin, and N-acetyl glucosaminidase (U-NAG) were measured.
Results U-β2M levels were significantly higher in acute appendicitis group compared to FMF group during attack period, FMF group during attack free period, and control groups (p<0.001, p<0.001, and p<0.001 respectively). U-NAG and microalbuminuria were significantly higher in acute appendicitis, FMF group during attack period, and FMF group during attack free period compared to controls (U-NAG p<0.001, p=0.016, p=0.004, microalbuminuria p<0.001, p<0.001, p<0.001 respectively). Microalbuminuria was significantly higher in acute appendicitis group compared to the FMF group during attack period (p=0.004).
Conclusions Determination of U-β2M levels may be helpful for differential diagnosis of peritonitis attacks of FMF patients on colchicine treatment, and acute appendicitis. However, this finding should be substantiated with other studies.
Disclosure of Interest None declared