TY - JOUR T1 - The Kidney in Familial Mediterranean Fever JF - The Journal of Rheumatology JO - J Rheumatol SP - 1948 LP - 1950 DO - 10.3899/jrheum.131135 VL - 40 IS - 12 AU - HAGIT PELEG AU - ELDAD BEN-CHETRIT Y1 - 2013/12/01 UR - http://www.jrheum.org/content/40/12/1948.abstract N2 - Familial Mediterranean fever (FMF) is a hereditary periodic fever disease that presents with recurrent attacks of peritonitis, pleuritis, arthritis, or erysipelas-like erythema1. The attacks last up to 3 days, with varying degrees of frequency. One of the most devastating complications of the disease is amyloidosis, which primarily affects the kidneys but can involve the liver, intestines, and the heart. Colchicine is the drug of choice for FMF2,3. It controls acute attacks of FMF and fends off development of amyloidosis. Since the introduction of colchicine for treatment of FMF, amyloidosis is infrequently seen among compliant patients.In the past, the mere presence of proteinuria in a patient with FMF suggested a diagnosis of renal amyloidosis since it was the most common kidney involvement in this disease. Nevertheless, more than 30 years ago, Eliakim, et al already reported that patients with FMF could have renal diseases other than amyloidosis4. Among these are hemorrhagic glomerulonephritis, chronic glomerulonephritis, Henoch-Schönlein nephritis, and polyarteritis nodosa (PAN). In another report in which Eliakim, et al studied 106 FMF patients, amyloidosis was found in only 13 of 19 patients with persistent albuminuria5. Renal biopsies in 4 of the 6 cases without amyloidosis showed minimal nondiagnostic changes, focal glomerulonephritis, or segmental glomerular sclerosis. Both studies were published prior to the introduction of colchicine treatment. More recently, Said, et al reported kidney biopsy pathologies in 15 patients with FMF and proteinuria6. Thirteen had urine protein of more than 1 g/24 h. Only 7 had amyloidosis, while 6 had mesangial proliferative glomerulonephritis (with IgA or IgM deposition), and 2 had rapidly progressive glomerulonephritis. Most of the patients were noncompliant for colchicine.Owing to the high efficacy of colchicine treatment in preventing amyloidosis and to the possible existence of other … Address correspondence to Dr. Ben-Chetrit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel, POB 12000. E-mail: eldad{at}hadassah.org.il ER -