MEDITERRANEAN FEVER

TYPES

Familial Mediterranean Fever type 1: characterized by recurrent fever and inflammation attacks in tissue linings of lungs, heart, abdomen, peritoneum, and rarely, swelling of the membranes covering the brain and spinal cord.  Renal failure is a complication that could result from type 1.

Familial Mediterranean Fever Type 2: the person is asymptomatic, and the first and only manifestation of the condition in this type is amyloidosis.

SYMPTOMS

Signs and symptoms of Mediterranean fever usually start to manifest during childhood. They occur in periodic attacks that last for one to four days. There are seven types of attacks, and most involve fever.

• Abdominal attacks: abdominal pain with signs of inflammation of the intestinal lining (peritonitis), and pain similar to appendicitis. 95% of all patients experience this attack.
• Joint attacks: joint pain, especially in the legs. 75% of all patients experience this attack.
• Chest attacks: difficulty in breathing or lying flat, signs of inflammation of the pleura (pleuritis), and swelling of the pericardium (pericarditis).
• Scrotal attacks: scrotal pain due to inflammation of tunica vaginalis
• Muscle pain or pain in groups of muscle (myalgia)
• Erysipeloid: skin reaction on the legs that mimic cellulitis
• Fever without any symptoms mentioned above. It may be the only symptom present during childhood.

DIAGNOSIS

The doctor may conduct a physical exam and ask about your signs and symptoms. Mediterranean fever is genetically inherited, so the doctor will also inquire about your family’s medical history. Some tests and procedure are also used, such as:

• Blood tests: test results may show indicators of inflammation in your body
• Genetic testing: test results will determine if your gene contains a mutation associated with Mediterranean fever.

TREATMENT

Mediterranean fever cannot be cured. There are treatments, however, aimed to alleviate signs and symptoms.

• Colchicine: This drug reduces inflammation in the body and can help prevent attacks. However, the drug does not stop an episode/attack that has started already. Dosing varies for each patient; hence, you shall carefully work with your doctor to determine the suitable dose. With the correct dosage of colchicine, regular intake can help children with the condition live a healthy life and have an average life expectancy.

People whose symptoms are not controlled with colchicine; may be given different medications. Medications that can block proteins that cause inflammation, such as canakinumab. Rilonacept, and anakinra; analgesics/NSAIDs may also be suggested.

Generally, Mediterranean fever attacks are short-lasting, and hospital admission is hardly necessary. But in cases that attacks are frequently recurrent, patients may need to talk this through with their doctor. The doctor will screen the patient for possible trigger factors, such as drug interactions, and adjust the treatment base.