Colchicine enhances intestinal permeability in patients with familial Mediterranean fever

Objective: Colchicine therapy is complicated by frequent gastrointestinal adverse effects. Methods: We compared intestinal permeability in 21 patients with familial Mediterranean fever on long-standing colchine therapy (mean 5.8 years) and significant gastrointestinal complaints and 12 untreated patients and 14 healthy volunteers. The double probe (lactulose/mannitol) permeability test was performed using a hyperosmolar test solution (1580 mosmol) and the differential urinary recovery ratios were calculated. Results: Familial Mediterranean fever patients on colchicine therapy had significantly higher lactulose/mannitol urinary excretion ratios (0.073) compared to untreated patients (0.035) and to healthy controls (0.021). Untreated familial Mediterranean fever patients had significantly greater urinary lactulose/mannitol recovery ratios than controls (P < 0.02). No correlation was found between the degree of enhanced permeability and the length of exposure to the drug or the severity of clinical symptoms. Conclusion: Intestinal permeability was significantly enhanced in patients with familial Mediterranean fever treated with colchicine.