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Familial mediterranean Fever and hypercoagulability

Oshrat E Tayer-Shifman1, Eldad Ben-Chetrit

  • 1Rheumatology Unit, Division of Medicine, Hadassah-Hebrew University Medical Center. Jerusalem, Israel.

Mediterranean Journal of Hematology and Infectious Diseases
|June 30, 2011
PubMed

Insights

Familial Mediterranean fever (FMF) is an autoinflammatory disease. Despite inflammation increasing clotting risk, thrombotic events are rare in FMF patients, possibly due to counterbalancing anticoagulant changes and colchicine treatment.

Area of Science:

  • Rheumatology
  • Genetics
  • Hematology

Background:

  • Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disease.
  • FMF involves recurrent inflammatory episodes like fever, peritonitis, pleuritis, and arthritis.
  • Systemic inflammation can promote a prothrombotic state by altering coagulation factors.

Purpose of the Study:

  • To investigate the occurrence of thrombotic events in patients with Familial Mediterranean fever.
  • To explore potential explanations for the observed frequency of thrombosis in FMF.

Main Methods:

  • Literature review of current available studies on FMF and thrombosis.
  • Analysis of personal clinical experience with FMF patients.

Main Results:

  • Thrombotic events purely related to FMF are reported as very rare in the literature and clinical experience.
  • Acute FMF attacks involve both procoagulant and anticoagulant/antifibrinolytic changes.
  • Colchicine, the primary FMF treatment, may reduce inflammation and hypercoagulability.

Conclusions:

  • The low incidence of thrombosis in FMF patients despite inflammatory triggers suggests complex hemostatic regulation.
  • Concurrent anticoagulant and fibrinolytic activities may counteract the prothrombotic tendency during FMF attacks.
  • Colchicine's anti-inflammatory effects likely contribute to a reduced thrombotic risk in FMF management.

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