Familial Mediterranean fever associated with menstruation. Efficacy of intermittent colchicine therapy

The majority of patients with familial Mediterranean fever have a random pattern of attacks without a clear prodrome. Continuous prophylaxis with colchicine has been shown to reduce the frequency of attacks. It is generally considered undesirable, however, to expose young patients to the potential adverse effects of continuous colchicine prophylaxis. The alternative of intermittent short courses of colchicine during acute attacks is often ineffective in patients without a clear prodrome. Case reports of patients with a pattern of attacks occurring 12-24 hours after the onset of menstrual bleeding have appeared. Such patients should be ideal candidates for intermittent colchicine therapy. A review of the literature reveals that a consistent pattern of attacks closely following the onset of menstruation is not uncommon. Such a patient is described who has responded completely to short courses of colchicine begun at the first sign of menstrual bleeding.