Performance of different diagnostic criteria for familial Mediterranean fever in children with periodic fevers: Results from a multicenter international registry

Erkan Demirkaya, Celal Saglam, Turker Turker, Isabelle Koné-Paut, Patricia Woo, Matteo Doglio, Gayane Amaryan, J. Frenkel, Yosef Uziel, Antonella Insalaco, L. Cantarini, M. Hofer, Sorina Boiu, Ali Duzova, Consuelo Modesto, Annette Bryant, D. Rigante, Efimia Papadopoulou-Alataki, Severine Guillaume-Czitrom, Jasmin Kuemmerle-DeschnerBenedicte Neven, H. Lachmann, Alberto Martini, Nicolino Ruperto, Marco Gattorno, S. Ozen, Project Eurofever Project

Research output: Contribution to journalArticlepeer-review


Objective. Our aims were to validate the pediatric diagnostic criteria in a large international registry and to compare them with the performance of previous criteria for the diagnosis of familial Mediterranean fever (FMF). Methods. Pediatric patients with FMF from the Eurofever registry were used for the validation of the existing criteria. The other periodic fevers served as controls: mevalonate kinase deficiency (MKD), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), cryopyrin-associated periodic syndrome (CAPS), aphthous stomatitis, pharyngitis, adenitis syndrome (PFAPA), and undefined periodic fever from the same registry. The performances of Tel Hashomer, Livneh, and the Yalcinkaya-Ozen criteria were assessed. Results. The FMF group included 339 patients. The control group consisted of 377 patients (53 TRAPS, 45 MKD, 32 CAPS, 160 PFAPA, 87 undefined periodic fevers). Patients with FMF were correctly diagnosed using the Yalcinkaya-Ozen criteria with a sensitivity rate of 87.4% and a specificity rate of 40.7%. On the other hand, Tel Hashomer and Livneh criteria displayed a sensitivity of 45.0 and 77.3%, respectively. Both of the latter criteria displayed a better specificity than the Yalcinkaya-Ozen criteria: 97.2 and 41.1% for the Tel Hashomer and Livneh criteria, respectively. The overall accuracy for the Yalcinkaya-Ozen criteria was 65 and 69.6% (using 2 and 3 criteria), respectively. Ethnicity and residence had no effect on the performance of the Yalcinkaya-Ozen criteria. Conclusion. The Yalcinkaya-Ozen criteria yielded a better sensitivity than the other criteria in this international cohort of patients and thus can be used as a tool for FMF diagnosis in pediatric patients from either the European or eastern Mediterranean region. However, the specificity was lower than the previously suggested adult criteria.

Original languageEnglish
Pages (from-to)154-160
Number of pages7
JournalJournal of Rheumatology
Issue number1
Publication statusPublished - Jan 1 2016


  • Autoinflammatory diseases
  • Children
  • Familial mediterranean fever
  • Livneh criteria
  • Tel Hashomer criteria
  • Yalcinkaya-Ozen criteria

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy


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