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Familial Mediterranean fever and multiple sclerosis
1Department of Neurology, Hacettepe University Hospitals, Ankara, Turkey. rk01-k@servis.net.tr
Abstract:
Central nervous system (CNS) manifestations of familial Mediterranean fever (FMF) are extremely rare. These include pseudotumor cerebri, optic neuritis, CNS complications of polyarteritis nodosa type vasculitis, or hypercoagulable states secondary to renal amyloidosis, recurrent aseptic meningitis, and amyloid ophthalmoplegia. We present three patients with FMF whose neurological findings and magnetic resonance imaging (MRI) abnormalities resembled multiple sclerosis (MS). These two conditions in the same patient could arise from either coincidence or an unknown pathophysiological relationship. Both explanations are equally speculative and this matter needs further study, especially to investigate MRI features in FMF patients without CNS symptoms.
Insights
Familial Mediterranean fever (FMF) rarely causes central nervous system (CNS) issues. Three FMF patients showed neurological symptoms and MRI results similar to multiple sclerosis (MS), suggesting a potential link needing further investigation.
Area of Science:
- Neurology
- Genetics
- Immunology
Background:
- Familial Mediterranean fever (FMF) is a genetic autoinflammatory disorder.
- Central nervous system (CNS) involvement in FMF is exceptionally rare.
- Reported CNS manifestations include aseptic meningitis, vasculitis, and amyloidosis complications.
Observation:
- Three patients with diagnosed FMF presented with neurological symptoms.
- Their neurological findings and MRI abnormalities mimicked those typically seen in multiple sclerosis (MS).
- This presentation is unusual given the rarity of CNS involvement in FMF.
Findings:
- The observed neurological and MRI findings in FMF patients resembled MS.
- The co-occurrence of FMF and MS-like symptoms raises questions about potential shared pathways or coincidence.
- Further research is needed to understand this association.
Implications:
- This case series highlights the importance of considering neurological assessments in FMF patients with unexplained symptoms.
- Investigating MRI features in FMF patients, even without overt CNS symptoms, may reveal subclinical abnormalities.
- Understanding the relationship between FMF and MS could lead to new diagnostic or therapeutic strategies.