Multiple and varied mechanisms have been proposed to underlie the difference in occurrence of amyloid nephropathy in patients with familial mediterranean fever (FMF). However, the precise mechanism(s) has, thus far, remained enigmatic.1
We have recently reviewed the 10-year follow-up of a group of 51 patients with FMF living in Mexico City. Thirty-five patients were male and 16 were female; thirty-eight patients had been born in Mexico City and the rest in Syria; the median age of the group was 39 years (range, 4 to 77 years); the median age at onset of symptoms was 17.54±12.54 years. The most frequent complaint was abdominal involvement (n=51), followed by fever (n=50), pleuritis (n=11), and arthritis (n=9). Abdominal involvement had been so severe that it led to surgical intervention in 46 of our patients. Urinalysis, done every 3 months in all but three patients, did not reveal protein urinary excretion during the 10-year