In this paper we want to demonstrate whether higher than normal levels of RDW, and lower than normal levels of MPV can be used as indicators of subclinical inflammation and tools for treatment decision in FMF or not. The participants in this study included 89 patients with FMF during attack-free periods and 30 healthy controls. The RDW and platelet counts were significantly higher, while the MPV was significantly lower in the patients with FMF group than healthy control group ( ; ; , resp.). In the attack-free FMF group, a negative correlation was found between the MPV and RDW values ( , ). The positive correlation was found between the RDW and ESR ( , ). And the negative correlation was found between the MPV and CRP ( , ). Consequently, our results suggest that low MPV and high RDW levels may provide additional information about subclinical inflammation in FMF patients. But other strong predisposing factors affecting subclinical inflammation in FMF should be considered. Further studies with large numbers of patients are needed. Treatment of FMF should include not only prevention of acute attacks but also decreasing of the subclinical inflammation. 1. Introduction Familial Mediterranean fever (FMF) is characterized by recurrent and self-limiting attacks with peritonitis, pleuritis, arthritis, and erysipelas-like erythema. It is inherited as an autosomal recessive trait and prominently presents among Sephardi Jews, Turks, Armenians, Arabs, and, to a much lesser extent, other ethnicities [1–3]. The attacks of FMF are only the tip of the iceberg, and inflammation maintains in attack-free remission periods in 30% of patients with FMF [4]. This maintaining subclinical inflammation induces endothelial dysfunction and increases the risk of developing significant complications such as atherothrombosis, anemia, splenomegaly, decreased bone mineral density, heart disease, and life-threatening secondary systemic amyloidosis [5, 6]. Subclinical inflammation is shown by high levels of acute-phase proteins, cytokines, and inflammation-induced proteins (e.g., overproduction of C-reactive protein (CRP) or serum amyloid-A (SAA) and persistently elevated fibrinogen levels and erythrocyte sedimentation rates (ESR)) in attack-free FMF periods [5, 7–9]. Red cell distribution width (RDW) is commonly accepted as part of the hemogram and refers to the changeability in the size of the erythrocytes in the peripheral circulation. RDW is used to refer to the differential diagnosis of anemia, and it increases during inflammation; therefore, RDW can increase as a result of chronic
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