Management of familial Mediterranean fever
- Stephen E Goldfinger, MD
Stephen E Goldfinger, MD
- Professor of Medicine Emeritus
- Harvard Medical School
Familial Mediterranean fever (FMF) is characterized by sporadic, paroxysmal attacks of fever and serositis, with intervening asymptomatic periods that may range from as little as one week to many months. The major cause of mortality is the insidious development of secondary (AA) amyloidosis with eventual renal failure. (See "Pathogenesis of secondary (AA) amyloidosis".)
The goals of therapy for FMF are twofold:
●Prevention of acute attacks
●Prevention of the development and progression of amyloidosis
Early attempts to treat FMF with a variety of measures, including antibiotics, glucocorticoids, salicylates, antihistamines, antimalarials, and low-fat diets, used either prophylactically or during acute attacks, provided little benefit. It has now become clear that the disease can be managed successfully only by prophylactic treatment with colchicine.
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- PREVENTION OF ATTACKS WITH COLCHICINE
- Colchicine unresponsiveness
- - Intravenous colchicine
- - Interferon alfa
- - Miscellaneous
- Prodrome-initiated colchicine therapy
- Possible mechanisms of colchicine in FMF
- PREVENTION OF AMYLOIDOSIS WITH COLCHICINE
- SAFETY OF COLCHICINE
- Use in children
- Use in pregnancy
- SUMMARY AND RECOMMENDATIONS