[Synovitis in familial Mediterranean fever]

Area of Science:

• Rheumatology
• Genetics
• Pathology

Background:

• Familial Mediterranean Fever (FMF) is an autosomal-recessive autoinflammatory disorder.
• FMF commonly presents with recurrent episodes of fever and serositis, but arthritis, particularly of the knee, can also occur.
• Understanding thePathophysiology of FMF-induced arthritis is crucial for effective management.

Observation:

• Arthroscopy in a patient with FMF-associated knee arthritis revealed significant subsynovial granulocytic infiltration.
• Synovial blood vessels showed marked ectasia and hyperemia during the acute phase.
• Synovial fluid analysis demonstrated high cell counts and lactate levels, similar to bacterial arthritis, despite a sterile environment.

Findings:

• The primary finding is intense granulocytic infiltration in the subsynovium, characteristic of acute inflammation.
• Microbiologically sterile synovial fluid exhibited inflammatory markers comparable to septic arthritis.
• The study confirmed the efficacy of prophylactic colchicine in symptomatic management, emphasizing regular intake and patient education.

Implications:

• These findings highlight the inflammatory nature of FMF arthritis and its resemblance to infectious arthritis at a cellular level.
• The results underscore the importance of early diagnosis and consistent treatment with colchicine for FMF patients.
• Further research into the specific inflammatory pathways in FMF arthritis may reveal novel therapeutic targets.