Liver function changes in pediatric FMF: exploring disease dynamics and therapy impacts
Büşra Başer Taşkın1, Ayşenur Doğru Kılınç1, Selen Duygu Arık1
1Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey.
European Journal of Pediatrics
|October 20, 2025
Summary
Colchicine treatment for Familial Mediterranean Fever (FMF) in children typically causes mild, temporary liver function test elevations. These liver enzyme changes are generally manageable, indicating colchicine
Area of Science:
- Pediatric Rheumatology
- Autoinflammatory Diseases
- Hepatology
Background:
- Familial Mediterranean Fever (FMF) is the most common autoinflammatory disease, managed with colchicine.
- Colchicine, while effective, has a narrow therapeutic index and potential adverse effects, including hepatotoxicity.
- Monitoring liver function is crucial in pediatric FMF patients on long-term colchicine therapy.
Purpose of the Study:
- To assess the impact of colchicine on liver function tests (LFTs) in children with FMF.
- To investigate potential causes of LFT elevations in this cohort.
- To monitor the clinical course of liver enzyme abnormalities during colchicine treatment.
Main Methods:
- Retrospective analysis of pediatric FMF patients with LFT elevation ≥2 weeks after starting colchicine.
- Data collection included demographics, clinical features, MEFV variants, disease severity, colchicine dose, and comorbidities.
- LFT elevations were categorized, and patients were followed for normalization or persistent abnormalities.
Main Results:
- Most LFT elevations (94.4%) were mild and normalized within a month for 74% of patients.
- LFT abnormalities appeared after a median of 46.5 months of colchicine treatment.
- Hepatosteatosis and obesity were more common in patients with recurrent/persistent LFT elevations.
Conclusions:
- Colchicine-associated LFT elevations in pediatric FMF are typically mild, transient, and manageable.
- Colchicine appears safe for the liver in this population, but ongoing monitoring is recommended.
- Further long-term studies are warranted to fully understand the safety profile.
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