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(Circulation. 2000;101:e71.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Recurrent Pericarditis as a Manifestation of Familial Mediterranean Fever

H. Ercan Tutar, MD

Assistant Professor in Pediatrics Pediatric Cardiologist

Ayten Imamoglu, MD

Professor in Pediatrics Pediatric Cardiologist

Semra Atalay, MD

Associate Professor in Pediatrics Pediatric Cardiologist, Ankara University Medical School, Department of Paediatric Cardiology, Ankara, Turkey

	Introduction

 
To the Editor:

We read with great interest the article by Adler et al regarding colchicine treatment for recurrent pericarditis.¹ The authors described 51 patients from Israel, Spain, and the United States. The pericarditis was idiopathic in 33 patients and secondary in 18. Recurrences of pericarditis did not respond to conventional therapy consisting of nonsteroidal anti-inflammatory drugs, corticosteroids, pericardiocentesis, or some combination thereof and could only be controlled after the initiation of colchicine treatment. The authors concluded that colchicine was effective and safe for the long-term prevention of recurrent pericarditis, especially in idiopathic cases.

Colchicine therapy has been shown to be an effective method for eliminating attacks of familial Mediterranean fever (FMF), which is an autosomal recessive disorder characterized by recurrent and self-limited attacks of fever accompanied by inflammation of peritoneum, synovium, and pleura.² Pericardial involvement is a rare but well-known feature of the disease.² Tauber et al³ reported 2 patients who had recurrent pericarditis as an initial sole manifestation of FMF. Although pericardial inflammation has been considered rare, an incidence of pericardial involvement of 27% has been reported when echocardiography is used for the diagnosis.⁴ We also have 2 patients from Turkey (8- and 11-year-old girls) who had recurrent pericarditis as an initial feature of FMF. They had no further pericarditis attacks during 6 and 56 months of follow-up after initiation of regular colchicine therapy (unpublished data).

FMF is a disease that primarily affects Jews, Turks, Armenians, and Arabs.² Although Adler et al¹ did not mention their patients’ ethnic . . . [Full Text of this Article]

Yehuda Adler, MD; Yaron Finkelstein, MD

Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel

Joseph Guindo, MD; Anthony Rodriguez de la Serna, MD; Antony Bayes-Genis, MD; Antony Bayes de Luna, MD

Department of Cardiology and Rheumatic Disease, Hospital de Sant Pau, Barcelona, Spain

Yehuda Shoenfeld, MD

Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, Israel

Alex Sagie, MD

Department of Cardiology Rabin Medical Center Petah Tikva, Israel

David H. Spodick, MD

Cardiology Department, St. Vincent Hospital, Worcester, Mass