Familial Mediterranean Fever (FMF)

Familial Mediterranean fever (FMF) is a genetic disorder that causes recurrent episodes of inflammation in the body. It is a type of autoinflammatory disease, which means that it is caused by an overactive immune system. FMF is most commonly found in people of Mediterranean descent, but it can occur in people of other ethnic backgrounds as well. The symptoms of FMF can vary, but they usually include fever, abdominal pain, joint pain, skin rashes, and chest pain. These episodes of inflammation typically last for a few days, and then the symptoms go away. Over time, the episodes can become more frequent and longer-lasting. In some cases, FMF can cause serious complications such as kidney disease, arthritis, and damage to internal organs. The cause of FMF is a genetic mutation in a gene called MEFV. This gene is responsible for producing a protein called pyrin, which helps regulate the immune system. In people with FMF, the MEFV gene produces a defective form of pyrin, which causes the immune system to become overactive and attack the body.


The mutations in the MEFV gene result in an overactive inflammation response, leading to recurrent episodes of fever and pain in the abdomen, chest, and joints. These episodes can last for several days and can lead to the formation of amyloid deposits, which can cause damage to organs and tissues over time.

There are over 80 different mutations in the MEFV gene that have been identified, with varying severity and symptoms. The most common mutations are M694V and M680I.

In conclusion, the main cause of FMF is a genetic mutation in the MEFV gene, which leads to an overactive inflammation response and recurrent episodes of fever and pain.

The mutation in the MEFV gene causes an abnormal form of the pyrin protein to be produced, leading to an overactive inflammatory response in the body. This results in episodes of fever, pain, and swelling in various parts of the body, especially the abdomen and joints. In severe cases, the inflammation can lead to damage to internal organs such as the liver and kidneys.

FMF is an autosomal recessive disorder, meaning that a person must inherit two copies of the mutated gene (one from each parent) to develop the condition. It is estimated to affect 1 in 200 individuals of Mediterranean descent, with the highest prevalence in Jews of Ashkenazi and Sephardic origin, Armenians, Arabs, and Turks.

In summary, the main cause of FMF is a genetic mutation in the MEFV gene, leading to the production of an abnormal form of the pyrin protein and overactive inflammation in the body.


Familial Mediterranean fever (FMF) is a genetic disorder that affects the body’s ability to control inflammation. The main symptoms of FMF include:

  1. Recurrent fevers: FMF is characterized by recurring episodes of high fever that last anywhere from a few hours to several days.
  2. Abdominal pain: Pain in the abdomen is a common symptom of FMF, which is usually located in the upper right quadrant of the abdomen.
  3. Joint pain: Joint pain and swelling can also occur during FMF episodes.
  4. Chest pain: Chest pain and pleuritis, or inflammation of the lining around the lungs, can also occur during FMF episodes.
  5. Skin rash: Some patients may develop a skin rash during FMF episodes.
  6. Muscle pain: Muscle pain and weakness can also occur during FMF episodes.
  7. Fatigue: Patients with FMF may experience significant fatigue and weakness during and after fever episodes.

These symptoms can vary from person to person and the frequency and severity of FMF episodes can also vary over time. It is important to see a doctor for a proper diagnosis and treatment plan.


Diagnosis: Familial Mediterranean fever (FMF) is a genetic autoimmune disorder that is primarily diagnosed through a combination of clinical presentation, family history, and genetic testing.

Test Details:

  1. Clinical evaluation: A physician will evaluate the patient’s symptoms, medical history, and family history to diagnose FMF.
  2. Blood tests: To diagnose FMF, a blood test is performed to measure the level of a specific protein called the C-reactive protein (CRP), which is often elevated during an attack.
  3. Genetic testing: Genetic testing is the most accurate way to diagnose FMF. A blood sample is collected and sent to a laboratory where the MEFV gene is analyzed for mutations.
  4. Inflammatory markers: During an FMF attack, other inflammatory markers such as ESR (erythrocyte sedimentation rate) and white blood cell count may also be elevated.
  5. Other tests: Other tests such as a joint aspirate or biopsy, echocardiogram, or abdominal ultrasound may be performed to exclude other causes of the symptoms.


The main treatment for FMF is a medication called colchicine.

Colchicine works by reducing inflammation in the body and preventing future episodes of fever and pain. It is usually taken orally once or twice a day, depending on the severity of the symptoms. The dosage may need to be adjusted over time to find the right balance for the individual patient.

In addition to colchicine, doctors may also prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain during an episode. In severe cases, corticosteroids may also be used to control inflammation.

The recommended dose is usually between 0.5-1.5 mg twice a day, but this can vary depending on the severity of symptoms and individual tolerance.

In addition to colchicine, other treatments may be recommended for patients with FMF. This can include pain relief medications for symptoms such as joint pain and fever, and anti-inflammatory drugs for severe inflammation. In some cases, steroids may be prescribed.

It is important for patients with FMF to work closely with their doctor to find the best treatment plan for their individual needs. Regular monitoring of symptoms and medication levels is also important to ensure that treatment is effective and to prevent potential side effects.

Overall, colchicine remains the main treatment for FMF, with NSAIDs and corticosteroids being used as needed to control symptoms. With proper management, most people with FMF are able to lead normal, healthy lives.