The evaluation of ENA-78 and fibrinogen levels for the differential diagnosis of familial Mediterranean fever and acute appendicitis

Abstract

Abstract Background Familial Mediterranean fever (FMF) is a disorder mainly present in the Mediterranean region, characterized by abdominal attacks that mimic acute peritonitis. Therefore, FMF might be confused with other conditions presenting with acute abdominal pain, particularly acute appendicitis (AA). We aimed to evaluate whether epithelial-derived neutrophil-activating peptide-78 (ENA-78) and fibrinogen levels and white blood cell (WBC) counts could be used as potential markers in the differential diagnosis of acute FMF attacks and AA. Methods The study involved three groups: patients with AA who underwent surgery (group 1, n = 30), patients with FMF attacks (group 2, n = 30), and patients with FMF who were attack-free (n = 30, controls), which included patients who were diagnosed as having FMF previously but had no attacks for a month. Results Significant differences were detected in the ENA-78 and fibrinogen levels between group 1 and group 2. No significant difference was found in the WBC count between group 1 and group 2. It was concluded that the WBC count was more sensitive (66%) for group 1, and fibrinogen showed higher sensitivity (86%) and specificity (96%) for group 2 compared with the other parameters. Conclusions We suggest that AA can be distinguished in patients with signs of peritonitis who were diagnosed as having FMF previously with the use of ENA-78 and fibrinogen levels; fibrinogen and ENA-78 might be helpful in discriminating between FMF attacks and AA.