Primary agent in profilaxy and treatment of FMF is colchicine. Which treatment would be most beneficial in FMF patients presented with amyloidosis but without classical symptoms of FMF, such as fever, abdominal pain or arthritis.
Colchicine is the best drug for treatment and prophylaxis of amyloidosis in FMF. Anti-TNF drug can be used if colchicine is not tolerated.
But amyloidosis is not only presented in FMF. In any chronic inflammation of GI tract (exp crohn's Dx or behcet Dx) amyloidosis can be available. In FMF, fever is special symptom, and without fever you have to doubt the diagnosis.
What do you think about FMF patients with phenotype 2, which is characterized by amyloidosis but no classical symptoms or signs of FMF?
In the dignostic criteria for diagnosis of FMF, amyloidosis is not available.
This criteria basis on; Livneh A, Langevitz P, Zemer D, et al. Arthritis Rheum 1997; 40:1879.
AA amyloidosis is secondary to untreated FMF.