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Background: Familial Mediterranean Fever (FMF) is the most common periodic fever syndrome, characterized by recurrent fever attacks and serosal inflammation accompanied by elevated acute phase reactants. While it often affects the young population, analyzing possible comorbidities and their impact on the disease is important for understanding whether they share a common etiological pathway.
Objectives: In this study, we aimed to evaluate the comorbidities of adult patients followed up in our clinic due to FMF.
Methods: This study is a cross-sectional study involving patients diagnosed with FMF according to the Tel-Hashomer criteria. Demographic characteristics were recorded. Colchicine dosage, duration of use, and observed side effects related to colchicine use documented. Comorbidities, genetic results and attack characteristics have been noted. Laboratory values were also noted, including erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) serum amyloid A (SAA).
Results: The study included 208 patients with a mean age of 36.7 (SD: 13.2) years, of whom 126 (60.6%) were women. The mean symptom duration was 12.8 (SD:9) years, disease duration was 9.26 (SD:7.4) years. The mean BMI of the patients was 24.9 (SD: 4.3), with 6 (2.9%) being underweight, 107 (52.5%) normal weight, and 91 (44.6%) overweight,. 112 (53.8%) of the patients were currently smoking. All patients were using colchicine, while 11 (5.3%) were using IL-1 inhibitors. During attacks, abdominal pain was observed in 192 patients (92.3%), chest pain in 94 patients (45.2%), fever in 95 patients (45.7%), myalgia in 115 patients (55.3%), arthritis in 44 patients (21.2%), and erysipelas in 11 patients (5.3%), while no patients had vasculitis. The mean colchicine dosage was 1.39 (SD: 0.4), with colchicine resistance observed in 14 patients (6.7%) and colchicine side effects in 1 patient (0.5%). There were 151 cases (72.6%) with a family history of FMF. The median number of attacks in the last 3 months was 1 (min-max:0-4), while in the last 6 months, it was 1 (min-max:0-6) (Table 1). In the genetic analysis results, the M694V homozygote was 25 (12.1%), M694V heterozygote was 22 (10.6%), and compound heterozygote was 23 (11.1%). 82 (39.4%) had an additional comorbidity, while 11 (5.2%) had 3 or more comorbidities. 22 (10.6%) hypertension, 19 (9.1%) cardiovascular disease, 13 (6.3%) diabetes, 13 (6.3%) hyperlipidemia, 11 (5.3%) renal, 10 (4.8%) gastrointestinal, 7 (3.4%) thyroid, 4 (1.9%) neurological, 4 (1.9%) pulmonary, 2 (1%) psychiatric, 2 patient had (1%) fibromyalgia. Inflammatory comorbidity is present in 31 (14.9%) patients, with spondyloarthropathy being the most common in 17 (8.2%) cases. Surgical comorbidity is present in 18 (8.7%) patients, including 5 (2.4%) who underwent appendectomy, and 5 (2.4%) with urological surgery. The mean Modified Charlson score of the patients was 0.6 (SD 1.2) and 67% had a value of 0 (Table 2).
Conclusion: Although Familial Mediterranean Fever (FMF) predominantly affects young adults, at least one comorbidity is detected in 39.4% of patients. Among these, spondyloarthritis/sacroiliitis is the most prevalent comorbidity in the inflammatory subgroup, while hypertension predominates in the incidental subgroup. The highly concerning complication of amyloidosis was detected in 5.3% of cases.
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[2] Priest RJ. Recurrent Polyserositis: Familial Mediterranean Fever, Periodic Disease, The Elsevier/North Holland Biomedical Press, Amsterdam, Oxford, and New York, New York (1981), By M. Eliakim, M. Levy, and M. Ehrenfeld. 227 pp., $59.75. WB Saunders; 1982.
[3] Alsarah A, Alsara O, Laird-Fick HS. Cardiac manifestations of Familial Mediterranean fever. Avicenna J Med. 2017;7(4):158-63.
Acknowledgements: NIL.
Disclosure of Interests: None declared.
© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (