Elucidation of the Mechanism of Attacks in Familial Mediterranean Fever through the accosiation with menstruation

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K15892
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: Shinshu University
• Principal Investigator: Kishida Dai 信州大学, 学術研究院医学系(医学部附属病院), 助教 (50467180)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 家族性地中海熱 / 発熱発作 / 月経 / 誘発因子 / コルヒチン

Outline of Final Research Achievements

The clinical characteristics of the female patients whose attacks were triggered by menstruation (menstrual-related patients) was shown below. The age at onset and the age at diagnosis in these patients was significantly lower than that in non-menstrual-related patients. Moreover, the percentage of patients with peritonitis was significantly higher in menstrual-related patients. The frequency of attacks, the percentage of symptoms other than peritonitis, and the response to colchicine treatment were not significantly different between the two groups. The proportion of patients complicating endometriosis was significantly higher in the menstrual-related group. With regard to the genetic features, the frequency of p.M694I mutation was higher in menstrual-related patients, but this was not statistically significant.

Free Research Field

自己炎症性疾患

Academic Significance and Societal Importance of the Research Achievements

女性FMF患者において月経は最大の発作誘発因子となることが示された。月経の度に熱が出る患者に遭遇した際、FMFを想起することの重要性が示されたと言える。子宮内膜症の合併率は高く、子宮内膜症そのものも炎症が関与しているとする研究もあり、両者の関連は興味深い。その他の発作誘発因子と異なり、月経は分かっていても回避することが難しいものではあるが、コルヒチン不応例、不耐例に対し、ホルモン療法が代替治療の一つになる可能性が示唆された。