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July 30, 1973

Periodic Peritonitis (Familial Mediterranean Fever)

Author Affiliations


JAMA. 1973;225(5):524. doi:10.1001/jama.1973.03220320052020

To the Editor.—  Several statements in the "Primer on Rheumatic Diseases" (224[suppl]:757, 1973) need comment. So-called familial Mediterranean fever (FMF) is not restricted to three ethnic groups. It begins at any time of life, and the frequency of amyloidosis probably results from a separate hereditary trait in a sect of patients in the Levant described by Heller et al.1 Amyloidosis seldom ensues otherwise. It also occurs occasionally in different periodic disorders probably partly dependent upon long-term hyperglobulinemia. Actual synovitis usually is polyarticular, not persistent for months. Exanthems and osteoporosis are rare features. No reference is made to any published divergent concepts.Familial Mediterranean fever, a widely accepted misnomer, is not always familial and has nothing to do with that sea, except for the concentration of susceptible ethnic groups in the locale. Abdominal pain, not fever, is the outstanding symptom. Brucellosis and leptospirosis also are known improperly as Mediterranean fevers,