Triggering factors for febrile attacks in Japanese patients with familial Mediterranean fever

Area of Science:

• Rheumatology
• Genetics
• Internal Medicine

Background:

• Familial Mediterranean Fever (FMF) is a genetic autoinflammatory disorder characterized by recurrent febrile attacks.
• Triggers for FMF attacks are not well-defined, particularly in specific ethnic groups.
• Understanding triggers is crucial for managing FMF and improving patient quality of life.

Purpose of the Study:

• To identify the specific factors that trigger febrile attacks in Japanese patients diagnosed with FMF.
• To investigate the prevalence and nature of these triggering factors.

Main Methods:

• Retrospective analysis of 372 Japanese FMF patients diagnosed between April 2007 and June 2018.
• Data collection through questionnaires assessing perceived triggering factors: anxiety, psychological stress, tiredness, excitement, environmental change, and menstruation.
• Evaluation of clinical features and genetic variants.

Main Results:

• Nearly half (49.4%) of FMF patients reported identifiable triggering factors.
• Psychological stress and tiredness were common triggers across both sexes.
• Menstruation was the most frequent trigger in female FMF patients (39.7%), linked to earlier onset, diagnosis, higher peritonitis rates, and increased endometriosis prevalence.

Conclusions:

• Identifying FMF attack triggers, such as psychological stress, tiredness, and menstruation, can aid in attack reduction and patient education.
• Clinicians should consider FMF in female patients experiencing fever and serositis coinciding with menstrual cycles.
• Further research into FMF triggers can personalize treatment strategies and improve patient outcomes.