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Familial Mediterranean fever: genotype-phenotype correlations in Japanese patients.
[familial mediterranean fever]
Familial
Mediterranean
fever
(
FMF
)
is
an
autoinflammatory
disease
caused
by
MEditerranean
FeVer
gene
(
MEFV
)
mutations
.
In
Japan
,
patients
with
FMF
have
been
previously
reported
,
including
a
mild
or
incomplete
form
.
Several
factors
are
presumed
to
contribute
to
the
variable
penetrance
and
to
the
phenotypic
variability
of
FMF
.
We
conducted
the
current
study
to
investigate
the
correlation
of
variable
clinical
presentations
and
MEFV
genotypic
distributions
in
Japanese
FMF
patients
.
We
analyzed
demographic
,
clinical
,
and
genetic
data
for
311
FMF
patients
enrolled
in
the
study
.
Clinically
,
we
classified
FMF
into
2
phenotypes
:
1
)
the
"
typical
"
form
of
FMF
,
and
2
)
the
"
atypical
"
form
of
FMF
according
to
the
Tel
Hashomer
criteria
.
Patients
with
the
typical
FMF
phenotype
had
a
higher
frequency
of
febrile
episodes
,
a
shorter
duration
of
febrile
attacks
,
more
frequent
thoracic
pain
,
abdominal
pain
,
a
family
history
of
FMF
,
and
MEFV
exon
10
mutations
.
Conversely
,
patients
with
the
atypical
FMF
phenotype
had
a
lower
frequency
of
fever
episodes
and
more
frequent
arthritis
in
atypical
distribution
,
myalgia
,
and
MEFV
exon
3
mutations
.
Multivariate
analysis
showed
that
the
variable
associated
with
typical
FMF
presentation
was
the
presence
of
MEFV
exon
10
mutations
.
Typical
FMF
phenotype
frequencies
were
decreased
in
patients
carrying
2
or
a
single
low
-penetrance
mutations
compared
with
those
carrying
2
or
a
single
high
-penetrance
mutations
(
M
694
I
)
,
with
an
opposite
trend
for
the
atypical
FMF
phenotype
.
In
addition
,
patients
having
more
than
2
MEFV
mutations
had
a
younger
disease
onset
and
a
higher
prevalence
of
thoracic
pain
than
those
carrying
a
single
or
no
mutations
.
Thus
,
MEFV
exon
10
mutations
are
associated
with
the
more
typical
FMF
phenotype
.
In
contrast
,
more
than
half
of
the
Japanese
FMF
patients
without
MEFV
exon
10
mutations
presented
with
an
atypical
FMF
phenotype
,
indicating
that
Japanese
FMF
patients
tend
to
be
divided
into
2
phenotypes
by
a
variation
of
MEFV
mutations
.
Diseases
Validation
Diseases presenting
"the more typical fmf phenotype"
symptom
familial mediterranean fever
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