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Familial Mediterranean Fever and Multiple Sclerosis Successfully Treated With Interferon Beta-1a: A Case Report
1Department of Neurology, Gülhane Training and Research Hospital, Ankara, Turkey.
Abstract:
Multiple sclerosis (MS) is the most common demyelinating disease in Turkey while familial Mediterranean fever (FMF) is the most common periodic fever syndrome worldwide. In this article, we report a 37-year-old male patient admitted with complaint of difficulty in walking. He had been taking colchicine at admission for 27 years. Despite this therapy, he had been experiencing twice monthly severe FMF attacks. After systemic and neurological examinations, laboratory tests and cranial and spinal magnetic resonance imaging, he was diagnosed as MS. Interferon (IFN) beta-1a was initiated three times/weekly subcutaneously for MS treatment. He stopped colchicine treatment after five months of IFN treatment because he did not suffer from any FMF attacks. He is still attack free for both diseases for a follow-up duration of 12 months. IFN beta is one of the most preferred agents for MS treatment but not one of the agents used for the treatment of FMF. Interferon beta can be a treatment of choice in patients with coincident FMF and MS and can be used in colchicine-resistant patients after being studied in systematic clinical studies.
Insights
This case study highlights a patient with multiple sclerosis (MS) and familial Mediterranean fever (FMF). Interferon beta-1a treatment for MS unexpectedly resolved FMF attacks, suggesting a potential new therapeutic avenue.
Area of Science:
- Neuroimmunology
- Rheumatology
- Genetics
Background:
- Multiple Sclerosis (MS) is a leading cause of demyelinating disease in Turkey.
- Familial Mediterranean Fever (FMF) is the most prevalent periodic fever syndrome globally.
- Co-occurrence of MS and FMF presents unique clinical and therapeutic challenges.
Observation:
- A 37-year-old male with a 27-year history of colchicine-treated FMF experienced persistent, severe monthly attacks.
- The patient was diagnosed with MS, necessitating treatment with Interferon (IFN) beta-1a.
- Neurological and systemic evaluations confirmed the diagnoses.
Findings:
- Following initiation of subcutaneous IFN beta-1a for MS, the patient ceased experiencing FMF attacks.
- The patient remained free of FMF attacks for 12 months after discontinuing colchicine.
- IFN beta-1a, a standard MS therapy, is not typically used for FMF.
Implications:
- IFN beta-1a may offer a novel therapeutic option for patients with coexisting MS and FMF.
- This finding suggests potential benefits for colchicine-resistant FMF patients.
- Further systematic clinical studies are warranted to validate IFN beta's efficacy in dual-diagnosis patients.
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