Background/Purpose:
Familial Mediterranean Fever (FMF) is an autoinflammatory disease characterized
by recurrent attacks of fever and serositis. Abdominal pain is the most
frequent symptom of these patients and approximately 95% of the FMF patients
experience an abdominal attack sometime during their illness. One of the main
concerns in FMF is the impaired oral intake and possible weight loss during
abdominal attacks. In this study, we aimed to investigate the association of
the clinical conditions with attack type, and weight status in patients with
abdominal attacks.

Methods: A group
of 118 consecutive patients with a diagnosis of FMF seen in a tertiary
rheumatology outpatient clinic were included in the study. The demographical,
laboratory, genetic and clinical features of the patients were recorded. Body
mass indexes were calculated as kg/m². Statistical analysis was made
with SPSS 22.0.

Results: 18 %
(n=21) of the patients were female. The mean age and BMI’s of the study group
were 29.05±8.69 (17-53) years and 24.28±3.5 (16.5-33.4) kg/m²,
respectively. The mean disease duration of these patients was 12.32±8.8 (0-39)
years. 26% (n=31) of patients were smokers. The levels of the inflammatory
markers did not differ significantly with predominant attack types. Patients
with arthritis attacks had lower BMI’s (23.7±3.4 vs 25.0±3.5 kg/m2, p=0.047)
compared to non-arthritis patients (Figure 1). Disease duration from the first
symptom or attack was significantly associated with serum uric acid
measurements (r=0.280, p=0.041)(Figure 2). BMI was significantly associated
with serum uric acid measurements (r=0.263, p=0.036). Patients with an
erysipelas-like erythema had lower serum magnesium levels (1.86±0.11 vs
2.06±0.14 mg/dl, p=0.013). Abdominal peritonitis attacks were associated with
lower diastolic arterial pressures (69.8±8.4 vs 73.8±5.4, p=0.024). Myositis
attacks and febrile myalgia were associated with higher serum creatinine kinase
levels (366.4±317.3 vs 108.5±48.5 U/L, p<0.001). The disease duration, genetic
mutation and smoking status lacked any significant association with BMI’s
(p=0.803, 0.269 and 0.512, respectively).

Conclusion: These
preliminary findings are needed to be confirmed in larger cohorts. Especially
the correlation between serum uric acid levels and higher disease duration may
point to higher cardiovascular risks of FMF patients in time.

Figure 1. Chart
showing the BMI differences of FMF patients in arthritis and non-arthritis
attacks (p=0.047).

Figure 2. The
chart showing the association between serum uric acid levels and disease
duration of FMF patients.