Colchicine
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Lack of efficacy: case report A 12-year-old girl exhibited lack of efficacy during treatment with colchicine for familial mediterranean fever (FMF). The girl had been diagnosed with FMF in January 2017 after the detection of the M694V heterozygous mutation on the Mediterranean fever (MEFV) gene. She had been receiving colchicine at a maximum dose of 2mg daily since January 2017 [route not stated]. She was hospitalised in August 2017 due to periodic abdominal pain and diarrhoea for a month. Her family history included FMF. On admission, a confirmed diagnosis of FMF was made because she fulfilled the Tel Hashomer and Ankara clinical diagnostic criteria for FMF. As a result, she was continued on colchicine at 2mg daily. She was in a poor general condition with a pale appearance. She also had fatigue, weight loss and anorexia. On further examination, she was found to have a nonspecific colitis secondary to FMF. Mesalazine was therefore started for the nonspecific colitis. Two weeks following the admission, she developed a mild proteinuria. She was diagnosed with colchicine-resistant FMF. As a result, anakinra was added to her ongoing colchicine therapy. Within a month, the girl’s proteinuria increased. Because of the advanced proteinuria, the dosage of anakinra was increased. On further examinations, she was diagnosed with underlying renal amyloidosis in September 2017 and Hodgkin’s lymphoma in October 2017. As a result, a chemotherapy protocol of doxorubicin, bleomycin, vinblastine and dacarbazine was initiated in October 2017. After the completion of chemotherapy, anakinra and colchicine were continued for the FMF and ongoing proteinuria. In April 2018, there was no evidence of malignancy and her proteinuria was found to be decreased. Demir F, et al. Systemic Amyloidosis in a Patient With Familial Mediterranean Fever and Hodgkin Lymphoma: A Case Report. Journal of Pediatric Hematology/Oncology 42: 234-237, No. 3, Apr 2020. Available from: URL: http://doi.org/10.1097/MPH.0000000000001504 803500869
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Reactions 12 Sep 2020 No. 1821
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