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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
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Summary

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.

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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.