Successful treatment of nephrotic syndrome due to FMF amyloidosis with azathioprine: report of three Turkish cases

• Published in: Rheumatology international 2006-12, Vol.27 (2), p.197-199
• Main Authors: Sayarlioglu, Hayriye, Erkoc, Reha, Sayarlioglu, Mehmet, Dogan, Ekrem, Soyoral, Yasemin
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Amyloidosis - complications; Amyloidosis - drug therapy; Amyloidosis - etiology; Antirheumatic Agents - therapeutic use; Azathioprine - therapeutic use; Colchicine - therapeutic use; Drug Therapy, Combination; Familial Mediterranean Fever - complications; Familial Mediterranean Fever - drug therapy; Female; Humans; Male; Nephrotic Syndrome - drug therapy; Nephrotic Syndrome - etiology; Proteins; Urine
• ISSN: 0172-8172; 1437-160X
• DOI: 10.1007/s00296-006-0188-2

Secondary amyloidosis is a well-known complication of certain familial Mediterranean fever (FMF). We presented three Turkish patients with FMF and biopsy proven amyloidosis. These patients were treated with colchicine 1.5 mg/day. They have experienced five to six peritonitis attacks with fever within 1 year. On admission, the laboratory test results were as follows: serum creatinine 2.3, 0.6, and 0.5 mg/dl; albumin 4.2, 1.9, and 1.8 g/dl; and urinary protein excretion 4, 15, and 10 g/day, respectively. All the patients were started azathioprine (AZA) 100 mg/day and attacks were completely stopped. Laboratory findings were as follows after 1 year of AZA treatment: serum creatinine 1, 0.8, and 0.6 mg/dl; albumin 4.3, 3, and 3.5 g/dl; and urinary protein excretion 3, 8, and 1.5 g/day, respectively. Treatment with azathioprine in addition to colchicine could ameliorate the nephrotic syndrome and control the attacks very effectively in these cases.