Nutritional status in children with familial Mediterranean fever

To determine the frequency of malnutrition, including undernutrition and overnutrition, in pediatric patients with familial Mediterranean fever (FMF), and to assess the impact of colchicine treatment on nutritional outcomes and factors associated with malnutrition.

The medical records of patients with FMF who were followed up in our pediatric rheumatology clinic between 2011 and 2024 were reviewed. Patients were divided into 3 groups according to their nutritional status: normal, undernutrition and overnutrition. Demographic and clinical characteristics and disease severity were compared before and after treatment. The international severity scoring system for FMF (ISSF) was used to assess disease severity.

This retrospective study included 532 (50.6% female) pediatric patients with a median (IQR) age at diagnosis of 6.5 (6) years. Malnutrition was detected in 32.7% of patients at the time of diagnosis, after colchicine treatment this rate declined to 20.7%, significant reductions in undernutrition (from 23.5% to 12.8%) and marginal improvements in overnutrition (from 9.2% to 7.9%) (p < 0.001) groups were observed. The ISSF was significantly higher in both the undernutrition and overnutrition groups compared to patients with normal nutritional status before and after colchicine treatment (p < 0.001). A severe disease phenotype and malnutrition at the time of diagnosis were identified as significant risk factors for persistent malnutrition (p < 0.001).

Malnutrition, including undernutrition and overnutrition, is a common condition in pediatric FMF patients that can be improved with colchicine. The presence of malnutrition at diagnosis and a more severe disease phenotype seemed to be the most important determinants of persistent malnutrition.