LAUSR

Background: Familial Mediterranean fever (FMF) is an auto inflammatory disease with recurrent attacks of serositis. Frequent attacks and disease related sequels may be associated with co-morbidities in FMF patients. Objectives: One of the tools for evaluating the FMF severity is the international severity scoring system for FMF (ISSF) 1. This score includes disease related sequels, acute phase measurements, attack features and exertional leg pain. Therefore, more severe disease may be link with subclinical inflammation, amyloidosis and frequent, prolonged and widespread attacks. All these components may augment the frequency of non-disease related co-morbidities. Methods: We enrolled 158 FMF patients who fulfilled modified Tel-Hashomer Diagnosis Criteria2. The patients dichotomized based upon disease severity (mild disease or severe disease). Patients with ISSF scores lower or equal to 2 were accepted to have mild disease. Then, we compared frequency of non-disease related co-morbidities between the groups. These co-morbidities are hypertension, hypothyroidism, hyperthyroidism cardiovascular diseases, coronary artery diseases, cerebrovascular diseases, chronic renal disease (non-FMF related), chronic obstructive pulmonary diseases, and diabetes mellitus. This study was approved by the Local Research Ethics Committee and carried out in compliance with the Helsinki Declaration. All the patients gave written informed consent. P-value lower than 0.05 was considered as statistically significant. Results: Demographic features, disease duration, smoking history and body mass index (BMI) were similar between the groups. Frequency of co-morbidity in severe disease group was statistically higher than mild disease group (p=0.02). Most frequent co-morbidity was hypertension in both groups.Table. Features of mild and severe FMF groups Mild (n=135) Severe (n=23) p Gender (M/F) 47/88 11/12 0.23 Age 36.4±11.3 36.5±14.3 0.68 Smoking (%) 38 (28.1) 5 (21.7) 0.52 BMI (kg/m2) 24.3±9.2 24.0±8.9 0.34 Disease duration (year) 7.7±11.3 8.6±14.3 0.09 Amyloidosis (%) 2 (1.4) 3 (13.0) 0.02 Exon 10 homozygote (%) 35 (25.9) 9 (39.1) 0.19 Colchicine dosage (mg/day) 1.2±0.4 1.4±0.5 0.02 ISSF scores 0.7 ±0.7 3.4±0.5 <0.001 Co-morbidity (%) 25 (18.5) 9 (39.1) 0.02 Conclusion: In our FMF patient cohort, we found that severity of the disease may be associated with higher frequency of co-morbidities. Therefore, clinicians should be aware of the high possibility of co-morbidities in patients with more severe FMF and addressed these co-morbidities timely and properly. References: [1]Demirkaya E, et al. Development and initial validation of international severity scoring system for familial Mediterranean fever (ISSF). Ann Rheum Dis 2016;75:1051-6. [2]Berkun Y, et al. Diagnostic criteria of familial Mediterranean fever. Autoimmun Rev 2014;13:388-90. Acknowledgments: None Disclosure of Interests: None declared