Increased risk of venous thromboembolism among patients with familial Mediterranean fever

Introduction: Familial Mediterranean Fever (FMF) is an auto inflammatory disease characterized by acute febrile attacks, serositis, arthritis and skin rash. Previous studies have identified an association between venous thromboembolism (VTE) and various inflammatory and autoimmune disorders, driven in large part by inflammatory processes. Despite these established associations, there remains a paucity of data linking FMF to VTE. The purpose of this study is to evaluate the association between VTE in patients with FMF compared to matched controls. Method: A population based cross-sectional study was performed utilizing the electronic medical database of Israel’s largest healthcare provider, Clalit Health Services. Using this database, we looked at the prevalence of VTE in a cohort of FMF patients compared to matched controls. Univariate logistic regression was used to evaluate the association between FMF and VTE. Multivariate analysis was conducted to adjust for age, sex, socioeconomic status and comorbidities associated with VTE. Results: A total of 6534 FMF patients were identified and matched with an equal number of controls. In univariate analysis the cumulative percent of VTE was higher in FMF patient compared to matched controls (FMF 3%, Control 2%). In a multivariate logistic regression analysis FMF was found to be independently associated with VTE (HR 1.96, P < 0.001). Conclusion: FMF is associated with increased risk of VTE. This association is likely the result of a chronic and persisting inflammatory state. Physicians should be aware of this sequela and care must be undertaken to control unbalanced disease.