CROHN'S DISEASE IN PATIENTS WITH FAMILIAL MEDITERRANEAN
Department of Gastroenterology, Chaim Sheba Medical Center, Sackler
Faculty of Medicine, Tel Aviv University, Telhashomer, Israel. hermafidder@...
Crohn disease and familial Mediterranean fever (FMF) are inflammatory
diseases characterized by abdominal pain and fever. The concurrence of the
2 diseases (FMF-CD) may pose a challenge to diagnosis and treatment. We
undertook the present study to determine the prevalence of Crohn disease
in FMF and to characterize FMF-CD patients clinically and genetically.
Using a computerized search, the patients of our FMF clinic were screened
for a concomitant diagnosis of Crohn disease. Patients and their medical
records were thoroughly examined, and their DNA was genotyped for
mutations in the MEFV gene. Control groups of ethnically and sex-matched
patients suffering from each of the diseases alone, either Crohn disease
or FMF, were used for comparison. We identified 7 patients with
concomitant Crohn disease and FMF, which is more than the expected
prevalence in the general population (p = 0.03). Crohn disease presented
at a significantly later age in the FMF-CD group (40.6 +/- 10.0 yr versus
26.2 +/- 11.4 yr; p < 0.004). Disease severity and other
characteristics of Crohn disease were comparable to the Crohn disease
control group. Contrary to the FMF control group patients, FMF in FMF-CD
patients was characterized by a higher attack frequency (p < 0.05) and
increased prevalence of amyloidosis (p < 0.02). The overall severity
score was similar in both groups. In conclusion, Crohn disease appears to
be more prevalent in FMF and presents later than in patients without FMF.
FMF in this group of patients shows a higher attack frequency and is more
often complicated by amyloidosis.