Related Experiment Videos
Crohn disease in patients with familial Mediterranean fever
Herma H Fidder1, Yehuda Chowers, Merav Lidar
1Department of Gastroenterology, Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Telhashomer, Israel. hermafidder@hotmail.com
Insights
Crohn disease is more common in familial Mediterranean fever (FMF) patients, presenting later in life. FMF in these patients has more frequent attacks and higher rates of amyloidosis.
Area of Science:
- Gastroenterology
- Rheumatology
- Genetics
Background:
- Familial Mediterranean fever (FMF) and Crohn disease (CD) are inflammatory conditions sharing symptoms like abdominal pain and fever.
- The co-occurrence of FMF and CD (FMF-CD) presents diagnostic and therapeutic challenges.
Observation:
- This study investigated the prevalence and clinical characteristics of FMF-CD.
- Patients with FMF were screened for CD, and genetic analysis of the MEFV gene was performed.
- Control groups of patients with isolated FMF or CD were used for comparison.
Findings:
- Crohn disease prevalence was higher in FMF patients than expected (p = 0.03).
- CD onset was significantly later in FMF-CD patients (40.6 years) compared to CD-only patients (26.2 years).
- FMF in FMF-CD patients showed increased attack frequency and a higher prevalence of amyloidosis compared to FMF-only patients.
Implications:
- Crohn disease may be more prevalent in individuals with familial Mediterranean fever.
- The distinct presentation and complications in FMF-CD patients necessitate tailored diagnostic and management strategies.
- Further research into the shared inflammatory pathways of FMF and CD is warranted.
Abstract:
Crohn disease and familial Mediterranean fever (FMF) are inflammatory diseases characterized by abdominal pain and fever. The concurrence of the 2 diseases (FMF-CD) may pose a challenge to diagnosis and treatment. We undertook the present study to determine the prevalence of Crohn disease in FMF and to characterize FMF-CD patients clinically and genetically. Using a computerized search, the patients of our FMF clinic were screened for a concomitant diagnosis of Crohn disease. Patients and their medical records were thoroughly examined, and their DNA was genotyped for mutations in the MEFV gene. Control groups of ethnically and sex-matched patients suffering from each of the diseases alone, either Crohn disease or FMF, were used for comparison. We identified 7 patients with concomitant Crohn disease and FMF, which is more than the expected prevalence in the general population (p = 0.03). Crohn disease presented at a significantly later age in the FMF-CD group (40.6 +/- 10.0 yr versus 26.2 +/- 11.4 yr; p < 0.004). Disease severity and other characteristics of Crohn disease were comparable to the Crohn disease control group. Contrary to the FMF control group patients, FMF in FMF-CD patients was characterized by a higher attack frequency (p < 0.05) and increased prevalence of amyloidosis (p < 0.02). The overall severity score was similar in both groups. In conclusion, Crohn disease appears to be more prevalent in FMF and presents later than in patients without FMF. FMF in this group of patients shows a higher attack frequency and is more often complicated by amyloidosis.