What is FMF?
FMF, also known as Familial Mediterranean Fever, is a genetically inherited rheumatic disease characterized by recurrent abdominal pain and fever attacks. It occurs most often between the ages of 5 and 15. Although 90% of cases are diagnosed before the age of 20, diagnosis can be made at older ages. The disease is seen on average in 1 out of every 1000 people.
What are the symptoms of FMF?
The most important symptoms of the disease are abdominal pain and fever, which usually last for 2-3 days. attacks. Attacks recur at irregular intervals and the interval between attacks can range from a week to several months. Between attacks, the person is completely normal and has no complaints. Some patients may experience chest pain, pain and swelling in the joints, red rashes on the legs, vomiting and diarrhea, and pain and tenderness in the scrotum (testicles) during attacks.
How is FMF diagnosed?
There is no specific test for the diagnosis of FMF. After excluding other possible diseases, the diagnosis can be made by the doctor based on the presence or absence of the following findings:
1. Presence of clinical symptoms of FMF (sudden fever of unexplained cause, severe abdominal, chest and joint pain)
2. Family history (FMF in mother, father, siblings and relatives increases the risk)
3. Blood tests (Although there is an increase in white blood cells, sedimentation, CRP and fibrinogen levels during attacks, none of them are specific to the disease)
4. A positive response to the drug colchicine supports the diagnosis of FMF.
5. Genetic tests can support the diagnosis by showing the mutations that cause FMF disease.
Why is the diagnosis delayed?
It is difficult to diagnose FMF at the beginning because the findings that occur during attacks are not specific to the disease. . This disease is often confused with appendicitis due to abdominal pain and fever. Some patients may even undergo appendicitis surgery. It can be confused with other rheumatic diseases due to pain and swelling in the joints.
There are no laboratory findings specific to the disease. High sedimentation rate, increased CRP and fibrinogen levels seen during attacks are common findings of all inflammatory diseases and cannot be distinguished. They are not aversive. Genetic testing may aid diagnosis, especially in patients with atypical findings.
Who gets the disease? What is its hereditary aspect?
The disease is passed on genetically from mother and father to children. The mother or father may have FMF. However, this is not a requirement. Even if the mother and father appear completely healthy, if they are genetically carriers, their children may have FMF. The risk of developing FMF is also high in those whose close relatives have FMF disease.
Can prenatal diagnosis be made?
Genetic diseases such as FMF can be diagnosed from the 11th week of pregnancy. It can be detected by DNA analysis obtained from fetal samples taken since. However, FMF differs from other genetic diseases in that it is a treatable disease. For this reason, prenatal diagnosis is not performed for FMF today, as there is no need to terminate the pregnancy.
What is used in the treatment?
To completely eliminate FMF disease from the body. There is no treatment method that works. The most effective drug used is colchicine. This medicine is effective as long as it is used. The disease begins again in those who stop taking the drug. Therefore, colchicine treatment should be continued for life. In those who do not continue treatment regularly, the kidneys become damaged due to amyloidosis over the years. The patient enters kidney failure and may have to continue living as a dialysis patient. Patients should be monitored regularly for the development of kidney damage. The only way to protect from kidney failure is to use colchicine for life.
Biological agents in patients whose complaints cannot be controlled with colchicine. All of these drugs are injection drugs used together with colchicine.
Is the disease related to lifestyle?
Stress and extreme physical fatigue increase the frequency of attacks. may increase. Therefore, stress and excessive fatigue should be avoided. No relationship between the disease and diet and nutrition has been demonstrated.
Are there any herbal products that can be used other than drugs?
There is no herbal product whose effectiveness and reliability have been medically proven in the treatment of this disease. Use in treatment The colchicine we use may impair liver functions. Herbal products used together with colchicine may further negatively affect liver functions. A doctor should be consulted before using such herbal support products.
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