Mediterranean fever
Familial Mediterranean fever is a genetic autoinflammatory condition that causes repeated episodes of fever and inflammation. It commonly affects the abdomen, chest, joints, and sometimes the skin. Although the attacks may come and go, the condition requires proper diagnosis and long-term care to prevent complications.
Mediterranean fever is often seen in people with Mediterranean, Middle Eastern, Armenian, Turkish, Arab, or Jewish ancestry, but it can occur in other populations as well. The disease usually begins in childhood or adolescence, but some patients may be diagnosed later in life.
Our service focuses on identifying the condition early, reducing inflammatory attacks, protecting the joints and organs, and helping patients maintain a stable and active life.
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What Happens During an Attack?
During an attack, the immune system becomes overactive and triggers inflammation without an infection. This inflammation may affect the lining of the abdomen, chest cavity, joints, or other tissues.
A typical attack may last from one to three days and then improve on its own. However, repeated attacks can be painful, disruptive, and concerning for patients and families.
Common attack symptoms include:
- High fever
- Severe abdominal pain
- Chest pain
- Joint pain and swelling
- Muscle pain
- Skin rash, especially on the legs
- Fatigue after attacks
Because abdominal pain may be severe, Mediterranean fever can sometimes be mistaken for appendicitis or other emergency conditions.
Why Early Diagnosis Is Important
Early diagnosis is essential because untreated Mediterranean fever may lead to serious long-term complications. The most important complication is amyloidosis, a condition where abnormal protein deposits build up in organs, especially the kidneys.
If not controlled, amyloidosis may lead to kidney damage and long-term health problems. Proper treatment can significantly reduce this risk.
Diagnosis also helps patients understand why repeated fever attacks are happening and prevents unnecessary investigations or repeated emergency visits.
Causes and Genetic Factors
Familial Mediterranean fever is usually caused by mutations in the MEFV gene. This gene affects how the body controls inflammation. When the gene does not function properly, the immune system may trigger unnecessary inflammatory attacks.
The condition is commonly inherited in an autosomal recessive pattern, meaning a patient may inherit abnormal gene copies from both parents. However, inheritance patterns can vary, and genetic testing may help support the diagnosis.
A family history of similar fever attacks, abdominal pain, or kidney complications may increase suspicion of the disease.
Diagnostic Evaluation
Diagnosis is based on clinical symptoms, family history, ethnic background, and laboratory testing. Genetic testing may confirm MEFV gene mutations, but treatment decisions often depend on the full clinical picture.
Evaluation may include:
- Detailed symptom history
- Family history assessment
- Blood tests during and between attacks
- Inflammatory markers such as CRP and ESR
- Kidney function tests
- Urine testing for protein
- Genetic testing when needed
The goal is to confirm the diagnosis, assess inflammation severity, and monitor for complications.
Treatment and Attack Prevention
The main treatment for Mediterranean fever is long-term colchicine therapy. Colchicine helps reduce the frequency and severity of attacks and protects against amyloidosis.
Treatment may include:
- Daily colchicine medication
- Anti-inflammatory medication during attacks
- Regular monitoring of kidney function
- Dose adjustment according to response
- Patient education about long-term adherence
It is very important that patients take medication consistently, even when they feel well, because prevention is the main goal of treatment.
Joint and Musculoskeletal Care
Mediterranean fever can affect joints, especially knees, ankles, and hips. Joint inflammation may cause pain, swelling, warmth, and difficulty walking during attacks.
Musculoskeletal care may include:
- Joint examination during flare-ups
- Pain and inflammation control
- Physical activity guidance
- Rehabilitation after severe attacks
- Monitoring for recurrent joint involvement
Most joint attacks improve, but repeated inflammation should be assessed carefully to protect mobility.
Long-Term Monitoring and Lifestyle Support
Patients with Mediterranean fever need regular follow-up to monitor disease control and prevent complications.
Long-term care may include:
- Monitoring attack frequency
- Checking inflammatory markers
- Kidney and urine testing
- Reviewing medication tolerance
- Lifestyle advice to reduce triggers
- Family counseling when needed
Some patients notice attacks triggered by stress, infections, intense exercise, or fatigue. Recognizing personal triggers can help improve disease control.
Our Care Goal
Our goal is to provide complete care for patients with familial Mediterranean fever through accurate diagnosis, preventive treatment, joint care, and long-term monitoring.
With proper treatment and consistent follow-up, most patients can reduce attacks, protect kidney health, maintain mobility, and live a normal, active life.
