Iron Deficiency in Familial Mediterranean Fever: A Study on 211 Adult Patients from the JIR Cohort

Ilenia Di Cola¹, Lea Savey², Marion Delplanque³, Rim bourguiba³, Alessandra Bartoli⁴, Zohra Aknouche³, Fatima Bensalek³, Isabelle Kone Paut⁵, Linda Rossi Semerano⁵, Isabelle Melki⁶, Brigitte Bader-Meunier⁷, Bénédicte Neven⁶, PIERRE QUARTIER⁸, Guilaine Boursier⁹, Irina Giurgea¹⁰, Laurence Cuisset¹¹, Gilles Grateau³, Veronique Hentgen¹² and Sophie Georgin-lavialle¹³, ¹University of L'Aquila, L'Aquila, Italy, ²Internal Medicine Department, Tenon Hospital, AP-HP, Paris, France, france, France, ³Internal Medicine Department, Tenon Hospital, AP-HP, Paris, France, Paris, France, ⁴Internal Medicine Department, Tenon Hospital, AP-HP, Paris, France, italy, Italy, ⁵Kremlin Bicêtre hospital, Le Kremlin Bicêtre, France, ⁶Necker Hospital, Paris, France, ⁷Necker Hospital, Assistance Publique Hopitaux de Paris, Paris, France, ⁸Université Paris-Cite, IMAGINE Institute, Necker Children’s Hospital, Paris Cedex 15, France, ⁹University of Montpellier, Montpellier, ¹⁰Trousseau hospital, Paris, France, ¹¹Cochin hospital, Paris, France, ¹²Laboratoire de Génétique des Maladies Rares et Autoinflammatoires, Département de Génétique Médicale, Maladies Rares et Médecine Personnalisée, CEREMAIA, CHU de Montpellier, Univ Montpellier, Montpellier, France, Le Chesnay, France, ¹³Sorbonne Université, Department of internal medicine, Tenon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France

Meeting: ACR Convergence 2024

Keywords: Fatigue, FMF, gender

Session Information

Date: Monday, November 18, 2024

Title: Miscellaneous Rheumatic & Inflammatory Diseases Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease worldwide. Fatigue is known to trigger FMF attacks. So far, no association has been reported iron deficiency and fatigue in FMF patients. Our aim was to evaluate the prevalence of iron deficiency in FMF patients and its association with clinical features, laboratory parameters, disease activity and outcomes over time.

Methods: A retrospective evaluation of prospectively followed FMF patients at the French National Reference Centre displaying two pathogenic exon 10 MEFV mutations was performed.

Results: Of 211 patients, 67 (31.8%) had a serum ferritin level < 27 ng/mL and were defined as iron deficient. Of these, 61 (91.0%) were female with a mean age of 36.81 (± 17.03) years. Among the 67 patients with iron deficiency, 132 (62.6%) displayed anemia (Hb < 13.0 g/dL). FMF patients with iron deficiency had lower Hb (p < 0.001) and BMI (p=0.023) and were significantly younger than those without iron deficiency (p=0.004), but they did not have more elevated inflammatory biomarkers. Female gender (p=0.0015) was associated with lower ferritin levels.

Conclusion: Iron deficiency, which mainly affects young women regardless of their level of inflammation, may be secondary to excessive gynaecological losses. Iron-deficient FMF patients may be more tired, which may lead to an increase in FMF attacks. Thus, it may be important to correct iron deficiency because this condition alone can cause asthenia, even in the absence of anemia. Interestingly, ferritin doesn’t seem to have pro-inflammatory properties in FMF. In conclusion, this work highlights the importance of measuring ferritin levels in FMF patients to detect iron deficiency in the absence of anemia.

Disclosures: I. Di Cola: None; L. Savey: None; M. Delplanque: None; R. bourguiba: None; A. Bartoli: None; Z. Aknouche: None; F. Bensalek: None; I. Kone Paut: None; L. Rossi Semerano: None; I. Melki: None; B. Bader-Meunier: None; B. Neven: None; P. QUARTIER: Abbvie, 2, 5, 6, BMS, 2, 5, 6, Chugai-Roche, 2, 5, 6, Novartis, 2, 5, 6, Pfizer, 2, 5, 6, Sweedish Orphan Biovitrum, 2, 5, 6; G. Boursier: None; I. Giurgea: None; L. Cuisset: None; G. Grateau: None; V. Hentgen: None; S. Georgin-lavialle: None.

To cite this abstract in AMA style:

Di Cola I, Savey L, Delplanque M, bourguiba R, Bartoli A, Aknouche Z, Bensalek F, Kone Paut I, Rossi Semerano L, Melki I, Bader-Meunier B, Neven B, QUARTIER P, Boursier G, Giurgea I, Cuisset L, Grateau G, Hentgen V, Georgin-lavialle S. Iron Deficiency in Familial Mediterranean Fever: A Study on 211 Adult Patients from the JIR Cohort [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/iron-deficiency-in-familial-mediterranean-fever-a-study-on-211-adult-patients-from-the-jir-cohort/. Accessed .

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