Clinical differences between North African and Iraqi Jews with familial Mediterranean fever

✍ Scribed by Ehrenfeld, Michael; Levy, Micha

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 1 KB
• Volume: 82
• Category: Article
• ISSN: 0148-7299
• DOI: 10.1002/(sici)1096-8628(19990219)82:5<442::aid-ajmg16>3.0.co;2-1

✦ Synopsis

Pras and colleagues [1998], in this Journal, recently compared the severity of familial Mediterranean fever (FMF) between North African and Iraqi Jews. They describe a more severe disease in the North African patients manifested by an earlier age of onset, an increase in severity and frequency of the joint involvement, a higher incidence of erysipelas-like erythema, and a higher dose of colchicine required to control the symptoms. However, they failed to point out that similar findings were published by the FMF group of the Hadassah University Hospital in Jerusalem [Levy et al., 1980] some 18 years ago.

We reported that the North African patients manifested an increased familial incidence, earlier onset of symptoms, and a higher frequency of arthritis. We suggested at the time that the immune response of North African patients differed from that of subjects of other ethnic origins. Additional study has shown that autoimmune mechanisms do not play a major role in the pathogenesis of the FMF. Recently, several mutations of the gene causing the disease have been mapped and cloned [French FMF Consortium, 1997;International FMF Consortium, 1997]. Allelic heterogeneity could well explain the inter-ethnic variation in the clinical manifestations of this disease.