Özet:

Objective: The aim of this study is to investigate the effects of recurrent inflammation and amyloid deposition on salivary and thyroid gland elasticity in pediatric patients with Familial Mediterranean Fever (FMF) using shear wave ultrasound elastography. Material and Method: This study included 31 patients with a diagnosis of FMF. At the time of imaging, 22 patients were admitted to the rheumatology department with an acute attack (45% girls, mean age±SD: 13.3±4.6 years). The remaining nine patients had histopathologically proven amyloidosis (50% girls, mean age±SD: 17.4±7.1 years). The control group comprised 40 healthy children (50% girls; mean age: 11.6±4.6 years). Shear wave elastography (SWE) measurements of the bilateral parotid, submandibular and thyroid glands were performed. Results: The median shear wave elasticity and velocity values of the salivary and thyroid glands in FMF patients imaged during an acute attack and patients with amyloidosis were significantly higher compared to the normal control subjects. However, the elastography values between FMF patients imaged during acute attack and patients with amyloidosis were not significantly different. The cut–off values for differentiation of patients with FMF from control subjects were 9.1 kPa, 9 kPa and 9.9 kPa for parotid, submandibular and thyroid glands, respectively. There were moderate negative correlations between thyroid (r=-0.6, p=0.008) and parotid gland (r=-0.4; p=0.04) elasticity with C-reactive protein and between serum amyloid A with thyroid gland elasticity (r=-0.58, p=0.018). Conclusion: Both acute inflammation and amyloid deposition would contribute to increased tissue stiffness. SWE might reflect clinically occult changes in salivary and thyroid glands that could not be demonstrated by routine gray scale ultrasonography in patients with FMF.

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