Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, 53 Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey.
Intern Emerg Med. 2024 Jun;19(4):1007-1013. doi: 10.1007/s11739-024-03576-w. Epub 2024 Mar 15.
Several possible factors are hypothesized to trigger familial Mediterranean fever (FMF) attacks; however, there is no consensus on this matter. We aimed to identify these triggering factors and analyze their relationship with the Mediterranean fever gene mutation status. We prepared a questionnaire that included the most commonly mentioned possible trigger factors of familial Mediterranean fever. We administered a questionnaire to 882 patients. We used a questionnaire assessing the following: psychological stress, consumption of tea and coffee, relationship with menses, menopause and post-menopausal alleviation, seasonal changes, traveling for long durations, relocation, starvation, sleeplessness, cold exposure, fatigue, wind exposure, and humidity. The most frequent triggering factor for familial Mediterranean fever attacks was psychological stress (75.2%). Cold exposure was a statistically significant trigger in patients with exon 10 mutations. Humidity was a statistically significant trigger in patients with exon 2 mutations. Seasonal changes, traveling for long durations, relocation, and cold exposure were statistically significant triggers of familial Mediterranean fever attacks in patients with homozygous M694V mutations. Identifying trigger factors can lead to better preventive measures and personalized therapies to decrease familial Mediterranean fever attacks. Patients can significantly decrease the number of familial Mediterranean fever attacks they experience by managing psychological stress and avoiding physical factors such as cold exposure and fatigue. Determining the relationship between trigger factors and patients' Mediterranean fever gene mutation status can lead to personalized therapy for the prevention of familial Mediterranean fever attacks.
几种可能的因素被假设为触发家族性地中海热 (FMF) 发作；然而，对此尚无共识。我们旨在确定这些触发因素，并分析它们与地中海热基因突变状态的关系。我们准备了一份问卷，其中包括家族性地中海热最常提到的可能触发因素。我们对 882 名患者进行了问卷调查。我们使用了一份评估以下因素的问卷：心理压力、茶和咖啡的摄入、与月经的关系、绝经和绝经后缓解、季节变化、长途旅行、搬迁、饥饿、失眠、暴露于寒冷、疲劳、暴露于风、湿度。家族性地中海热发作最常见的触发因素是心理压力 (75.2%)。冷暴露是 exon 10 突变患者的统计学显著触发因素。湿度是 exon 2 突变患者的统计学显著触发因素。在纯合 M694V 突变患者中，季节变化、长途旅行、搬迁和冷暴露是家族性地中海热发作的统计学显著触发因素。确定触发因素可以导致更好的预防措施和个性化治疗，以减少家族性地中海热发作。患者可以通过管理心理压力和避免寒冷暴露和疲劳等身体因素来显著减少家族性地中海热发作的次数。确定触发因素与患者地中海热基因突变状态之间的关系可以为预防家族性地中海热发作提供个性化治疗。
