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Growth Outcomes in Children with Familial Mediterranean Fever: A Question Beyond Chronic or Relapsing Inflammation

Ignazio Cammisa1, Clelia Cipolla2, Donato Rigante2,3

  • 1Department of Pediatrics, San Giovanni Evangelista Hospital, 00019 Tivoli, Italy.

Diseases (Basel, Switzerland)
|June 25, 2026
PubMed

Insights

Familial Mediterranean Fever (FMF) in children is often associated with preserved growth, especially with regular colchicine treatment. Early intervention and monitoring are key for managing growth in FMF patients.

Area of Science:

  • Pediatric Rheumatology
  • Genetics
  • Endocrinology

Background:

  • Familial Mediterranean Fever (FMF) is an autoinflammatory disease driven by MEFV mutations and IL-1β, potentially impacting growth via GH resistance.
  • Chronic inflammation in FMF may affect the GH-IGF-1 axis, but the extent and reversibility of growth deficits are not fully understood.

Purpose of the Study:

  • To review and assess available data on linear growth outcomes in pediatric patients diagnosed with Familial Mediterranean Fever.

Main Methods:

  • A scoping review following PRISMA guidelines was performed using the PubMed database.
  • Fourteen studies encompassing 1144 children were analyzed for height, growth velocity, IGF-1 levels, and treatment impacts.

Main Results:

  • Growth was generally preserved in most FMF children, with improved height standard deviation scores (HSDS) linked to earlier/higher colchicine doses.
  • While FMF severity and attack frequency showed modest influence, specific MEFV variants (e.g., M694V) and high disease activity posed risks for growth impairment.
  • IL-1 targeted biologics also demonstrated positive effects on HSDS, suggesting therapeutic benefits.

Conclusions:

  • Limited data suggest final height is preserved in the majority of pediatric FMF cases.
  • Consistent colchicine treatment is crucial for maintaining normal linear growth; IL-1 blockers are beneficial for refractory cases.
  • Regular growth monitoring and proactive medical check-ups are essential for children with FMF.
Keywords:
Familial Mediterranean feverchildrencolchicinecytokinesgrowthinflammationinterleukin-1personalized medicine

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