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Unbearable abdominal pains, rashes in the joints, high fever… Familial Mediterranean fever in children, namely FMF disease, is not an ordinary fever condition. What is FMF, is there any treatment, why did the child get this disease?
What is Mediterranean fever (FMF disease) in children?
Mediterranean fever in children, namely FMF (Familial Mediterranean Fever) disease, is a hereditary disease. Due to the similarity of the name, it is often confused with Mediterranean anemia, but these two diseases are different from each other.
FMF disease in children is common in people of Mediterranean and Middle Eastern origin, in Turkey, Cyprus and Israel.
What are the symptoms of Mediterranean fever in children?
- It occurs as attacks that occur once or twice a month, once a week in some children, and once every few months in others, usually lasting 24-48 hours.
- Severe abdominal pain occurs during episodes of familial Mediterranean fever disease.
- Fever in children rises up to 38-40 ºC.
- Fracture, shoulder, back and joint pain are seen.
- There may be red rashes around some joints.
- The findings are similar to appendicitis.
At what age does FMF disease occur?
Symptoms of familial Mediterranean fever disease usually appear between the ages of 5-15 years. Its incidence is low in later ages (especially after the age of 40) and before the age of 5 years.
What causes familial Mediterranean fever in children? What does it affect?
A gene called MEFV is responsible for FMF disease. This gene affects a protein that is involved in the natural resolution of inflammation. If there is a mutation in the structure of this gene, which is present in FMF disease, the inflammation does not resolve naturally, it accumulates in the body, causing a disease called amyloidosis and attacks. The most common is chronic renal failure.
Abdominal pain in children with Mediterranean fever is caused by inflammation of the peritoneum. This is not a microbial inflammation. It can also be seen in the membranes of the lungs and various joints.
How is the diagnosis of FMF disease in children made?
Diagnosis is made by investigating other possible diseases.
During the attack, blood tests such as sedimentation, CRP, fibrinogen, leukocytes are performed. In these analyzes, situations such as the detection of height during the attack, whether the values return to normal after the attacks have passed, and the characteristics of the attacks are examined.
Some genetic tests are also done when necessary. Gene testing is done in children and patients who do not have a typical episode of FMF. Genetic testing alone is not performed for the diagnosis of familial Mediterranean fever disease. Because a negative gene test is not enough to show that there is no mutation and that FMF disease has not occurred.
What is the treatment of familial Mediterranean fever in children? How does FMF work?
FMF patients need to take colchicine 2 or 3 times a day for life. This drug is extremely effective in preventing attacks. The biggest benefit is that it prevents amyloidosis that can be caused by Mediterranean fever disease in the kidney. Therefore, it is very important to use colchicine regularly. In other words, it is necessary not to quit when the pain subsides.
What kind of drug is colchicine? Are there any side effects?
A medicine derived from the autumn crocus flower. Colchicine is also used in the treatment of gout and Behçet’s disease. It has been observed that colchicine, which has few side effects, is not effective in only 5%-10% of children with FMF.
It is very important to use the medicine in the right dose. The biggest side effect is diarrhea. When colchicine causes diarrhea in your child, the doctor may reduce the dose. The fact that your child will be on medication for life can upset her morale. But FMF is an inherited disease. So it doesn’t get better with medication for a while. With colchicine treatment, the child can lead a normal life without the lifetime risk of developing amyloidosis.
What should FMF patients eat?
In children, FMF causes fever and inflammation, as we mentioned. If these effects are accompanied by vitamin D, the attack process may take longer. That’s why some experts think that eating fish and yogurt is effective in overcoming attacks more easily and in a short time.
In fact, you can follow a balanced diet program in order to recover the damage caused by familial Mediterranean fever on your child’s body. Otherwise, there is no such thing as children with FMF should eat this or not.
