Familial Mediterranean Fever and Transverse Myelitis: A Causal Relation?

Area of Science:

• Rheumatology and Neurology
• Autoinflammatory Disorders
• Neuroimmunology

Background:

• Familial Mediterranean fever (FMF) is a rare autoinflammatory disease causing fever and polyserositis.
• The link between FMF and demyelinating disorders, such as multiple sclerosis, remains debated.
• Neurologic complications in FMF are infrequently reported and poorly understood.

Purpose of the Study:

• To report the first case of transverse myelitis occurring after Familial Mediterranean fever attacks.
• To evaluate the efficacy of colchicine and rituximab in managing FMF-related transverse myelitis.
• To explore potential therapeutic strategies for colchicine-resistant FMF with neurological involvement.

Main Methods:

• Case report detailing a patient with FMF experiencing transverse myelitis.
• Treatment with colchicine for initial neurologic manifestations.
• Subsequent administration of rituximab for recurrent FMF and transverse myelitis episodes.

Main Results:

• Transverse myelitis developed following FMF attacks in the presented case.
• Neurologic symptoms resolved with colchicine treatment.
• Rituximab administration stabilized both FMF and transverse myelitis activity upon recurrence.

Conclusions:

• This case highlights transverse myelitis as a potential, albeit rare, neurologic complication of FMF.
• Colchicine can be effective for initial treatment, but rituximab may be a viable option for refractory cases.
• Rituximab shows promise in managing both FMF polyserositis and associated demyelinating conditions.