Background/Objectives: Familial Mediterranean fever (FMF) is the most common hereditary autoinflammatory syndrome, characterized by recurrent fever attacks and serositis. Galectin-3, a β-galactoside-binding lectin involved in inflammation and fibrosis, and presepsin, an established biomarker for bacterial infection and sepsis, have emerged as potential biomarkers for improving diagnostic and prognostic accuracy in autoinflammatory diseases. However, their use in FMF patients is not sufficiently evaluated. This study aims to compare serum galectin-3 and presepsin levels in children with FMF and healthy controls and assess their correlations with conventional acute-phase reactants. Methods: This prospective cross-sectional study included 74 children with confirmed FMF during attack-free periods and 67 age- and gender-matched healthy controls. Clinical and genetic characteristics, complete blood count, C-reactive protein (CRP), serum amyloid-A (SAA), and erythrocyte sedimentation rate (ESR) were recorded. Serum galectin-3 and presepsin levels were measured. Group comparisons and correlation analyses were performed using appropriate statistical tests. Results: Median serum galectin-3 and presepsin was significantly higher in FMF patients than controls (p < 0.001). ESR was significantly higher in FMF patients (p < 0.001), while CRP and SAA showed no significant differences. Correlation analysis revealed a strong positive correlation between galectin-3 and presepsin (r = 0.860, p < 0.001) in FMF patients, with neither correlating with other acute-phase reactants. Conclusions: Galectin-3 and presepsin were found to serve as novel biomarkers reflecting alternative inflammatory pathways in FMF, even during remission. These results, obtained during the attack-free period, indicate the need for further studies to determine the relationship between galectin-3 and presepsin levels and disease activity in FMF.

SUMMARY OBJECTIVE: Familial Mediterranean fever, an autoinflammatory disease, is characterized by recurrent stereotypic febrile attacks associated with an inflammatory syndrome. Malondialdehyde, a lipid peroxidation marker, and soluble transferrin receptor, a key regulator of cellular iron homeostasis, are important markers associated with ferroptosis. The aim of this study was to investigate the levels of these markers in children with familial Mediterranean fever in remission. METHODS: The study included 30 pediatric familial Mediterranean fever patients in remission who were being monitored in the hospital and 30 healthy children. Malondialdehyde and soluble transferrin receptor levels were analyzed using enzyme-linked immunosorbent assay. Malondialdehyde and soluble transferrin receptor levels were compared between groups. Correlation analyses were also performed separately for each group to assess the relationship between these two parameters. RESULTS: Serum amyloid A, erythrocyte sedimentation rate, and creatinine levels were higher and hematocrit levels were lower in the familial Mediterranean fever group compared to the control. No significant difference was found in malondialdehyde and soluble transferrin receptor levels between the two groups. There was a positive correlation between malondialdehyde and soluble transferrin receptor levels in both groups (familial Mediterranean fever r=0.803, control r=0.599). CONCLUSION: Although there was no significant difference in mean malondialdehyde and soluble transferrin receptor levels between children with familial Mediterranean fever in remission and a healthy control group, the high correlation coefficient between these two parameters in familial Mediterranean fever patients suggests a possible link between iron imbalance and oxidative stress in the pathophysiology of the disease. These findings highlight the need for larger, multicenter studies, including patients in the exacerbation phase, to better elucidate the role of ferroptosis in familial Mediterranean fever.

Background/Objectives: The effect of nutritional status on the prognosis of Familial Mediterranean Fever (FMF), a hereditary autoinflammatory illness, is unclear. This research aims to investigate whether nutritional status indicators, such as the Controlling Nutritional Status (CONUT) score and the Prognostic Nutritional Index (PNI), differ in kids with FMF compared to healthy kids. It also aims to investigate the possible relation between these indicators and the types of MEFV gene mutations detected in kids with FMF. Methods: The research included 90 kids with FMF and 90 healthy children as controls. The FMF group was further divided into three subgroups based on MEFV gene mutation status. The PNI and CONUT scores of these groups and subgroups were compared. Results: A difference was found in the distribution of CONUT scores in the FMF group compared to the healthy group. However, there was no difference in the distribution of PNI between the two groups. C-reactive protein, triglyceride, and total cholesterol values were higher in the FMF group than in the control group. A difference was also determined between the two groups in the distribution of total cholesterol scores categorized by CONUT score. A negative correlation was found between this categorized score and the number of symptom days. No significant difference was found in the distribution of PNI and CONUT scores among subgroups based on MEFV gene mutation status. Conclusions: In children with FMF, total cholesterol levels should be routinely monitored longitudinally, even if they remain within reference values, to prevent some complications in adulthood.

Background/Objectives: Febrile seizures (FS) are the most frequent seizure disorder in childhood. Growing evidence suggests that systemic inflammatory responses may contribute to FS pathogenesis. Easily accessible inflammatory markers derived from routine blood tests, including the neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and C-reactive protein-to-albumin ratio (CAR), have been investigated as potential indicators of inflammatory status. This study aimed to explore the association between these biomarkers and FS in children. Methods: The medical records of 401 children were retrospectively evaluated, including 200 patients diagnosed with FS and 201 age-matched controls without a history of seizures. Demographic data and laboratory parameters were obtained, and NLR, PNI, and CAR were calculated. Group comparisons were performed using appropriate statistical tests. Multivariable logistic regression was applied to determine independent factors associated with FS, and receiver operating characteristic (ROC) analysis was conducted to evaluate biomarker performance. Results: Compared with controls, children with FS had higher neutrophil counts, NLR, and CAR values, whereas lymphocyte counts and PNI values were lower (all p < 0.05). Male sex was more frequent in the FS group (62.5% vs. 47.8%, p = 0.004). In multivariable analysis, younger age, male sex, and increased NLR were independently associated with FS. However, CAR and PNI did not remain significant after adjustment. NLR showed the highest discriminative ability among the evaluated markers, although its diagnostic performance was limited (AUC = 0.647). Conclusions: NLR may reflect the inflammatory response associated with febrile seizures and could provide supportive clinical information. However, its moderate diagnostic accuracy prevents its use as a standalone diagnostic marker. Further studies are required to clarify its clinical utility.