Rare Diseases Symptoms Automatic Extraction

Diagnostic validity of colchicine in patients with Familial Mediterranean fever.

[familial mediterranean fever]

Although response to colchicine has been proposed as one of the diagnostic criteria in patients with Familial Mediterranean fever (FMF), the validity of this response has not been validated. The aim of this study was to assess the efficacy of the response to colchicine and to evaluate the extent of the effect of placebo. A double-blind randomized placebo-controlled trial with a cross-over design was conducted. The frequency of FMF attacks, the disease score, physical examination, and acute phase reactants were assessed at 0, 3, and 6 months. Blood samples were collected for complete blood count (CBC), erythrocyte sedimentation rate (ESR), levels of serum C-reactive protein (CRP) and serum amyloid A (SAA), and MEFV mutation analysis in 79 patients with a preliminary diagnosis of FMF. Patients were randomly allocated to receive either drug A or drug B in a double-blind fashion. The designated drug was switched at 3 months. Patients taking colchicine had less frequent FMF attacks (median 0) and lower FMF disease score (median 0) when compared to those on placebo (median 1 and 3, respectively) (p = 0.002 and p = 0.007, respectively). In genetically confirmed FMF patients, median attack number and median disease score was 0 under colchicine treatment, whereas these parameters were significantly higher in the placebo group (median 2 and 8, respectively) (p = 0.007 and p = 0.02, respectively) suggesting that colchicine is more effective than placebo in reducing attacks and disease score. Positive and negative predictive values were 70.2 and 37.5 %, respectively. During the placebo period, patients had less FMF attacks when compared to that of the pre-study period (median 2 vs 6, respectively) (p < 0.001). The high false positive rate raises concerns for considering the colchicine response test as diagnostic for FMF. The role of placebo on the attacks of periodic fever syndromes needs to be further investigated.

Diseases presenting "fever" symptom

  • 22q11.2 deletion syndrome
  • acute rheumatic fever
  • alexander disease
  • allergic bronchopulmonary aspergillosis
  • canavan disease
  • carcinoma of the gallbladder
  • child syndrome
  • congenital toxoplasmosis
  • cushing syndrome
  • cystinuria
  • dracunculiasis
  • erdheim-chester disease
  • esophageal adenocarcinoma
  • esophageal carcinoma
  • familial mediterranean fever
  • focal myositis
  • hodgkin lymphoma, classical
  • lamellar ichthyosis
  • legionellosis
  • locked-in syndrome
  • malignant atrophic papulosis
  • neonatal adrenoleukodystrophy
  • neuralgic amyotrophy
  • oculocutaneous albinism
  • papillon-lefèvre syndrome
  • pyomyositis
  • pyruvate dehydrogenase deficiency
  • scrub typhus
  • severe combined immunodeficiency
  • sneddon syndrome
  • systemic capillary leak syndrome
  • triple a syndrome
  • typhoid
  • waldenström macroglobulinemia
  • wolf-hirschhorn syndrome

This symptom has already been validated