Effect of an increased dose of colchicine on microalbuminuria in children with Familial Mediterranean Fever

Abstract

Aim of work

Familial Mediterranean Fever (FMF) is an autosomal recessive condition causing recurrent attacks of fever and polyserositis and may result in amyloidosis of the kidney. The aim of the present work was to investigate the response to an increased dose of colchicine in a group of Egyptian children suffering from FMF and albuminuria.

Patients and methods

40 FMF patients with microalbuminuria were prospectively followed up in the Pediatric Rheumatology Outpatient Clinic of Children’s Hospital, Cairo University, for a period of one year. All children were in an attack-free period and had no clinical evidence of renal disease. Colchicine doses were increased by 50%.

Results

Patients' mean age was 9.8 ± 3.08 years (5–17 years), disease duration was 3.96 ± 2.21 years (1–10 years) and were 15 males and 25 females. The mean dose of colchicine was 0.96 ± 0.46 mg/day and increased to 1.36 ± 0.46 mg/day during the study period. The new dose of colchicine was well tolerated by most patients with a few minor complaints of diarrhea and no affection of liver functions. The number of annual attacks decreased significantly with the increased doses of colchicines from 39.9 ± 22.43 attacks/year to 7.92 ± 4.92 attacks/year (p = 0.0001). Resolution of the microalbuminuria occurred in 50% within 3 months; another 30% responded within 6 months, and the remaining 20% responded after the 6th month of treatment. There was no significant association between the types of mutations and microalbuminuria.

Conclusion

Increased doses of colchicine are effective in treating microalbuminuria of FMF and should be given to children with frequently recurring attacks. All patients with FMF should be regularly screened for microalbuminuria.