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    Familial Mediterranean fever: perspective on female fertility and disease course in pregnancy from a multicenter nationwide network
    (Springer Heidelberg, 2023) Yurdakul, Fatma Gül; Bodur, Hatice; Çay, Hasan Fatih; Uçar, Ülkü; Keskin, Yaşar; Sargın, Betül; Gürer, Gülcan
    The aim of this study was to analyze the pregnancy process, especially the Familial Mediterranean fever (FMF) disease course and attack types during pregnancy, and to examine the relationship between disease-related factors and female infertility in FMF patients. The study, which was planned in a multicenter national network, included 643 female patients. 435 female patients who had regular sexual intercourse were questioned in terms of infertility. Pregnancy and delivery history, FMF disease severity and course during pregnancy were evaluated. The relationship between demographic and clinical findings, disease severity, genetic analysis results and infertility was investigated. 401 patients had at least 1 pregnancy and 34 patients were diagnosed with infertility. 154 patients had an attack during pregnancy. 61.6% of them reported that attacks during pregnancy were similar to those when they were not pregnant. The most common attack symptoms were fever, fatigue and abdominal pain-peritonitis (96%, 87%, and 83%, respectively) in the pregnancy period. The disease-onset age, disease activity score, gene mutation analyses, and regular colchicine use (> 90%) were similar between the fertile and infertile groups, while the frequency of previous appendectomy and alcohol consumption rates were higher in individuals with infertility. Our results indicated no significant change in the frequency and severity of attacks during pregnancy. The low rate of infertility (7.8%) in our patients was noted. It has been suggested that the risk of FMF-related infertility may not be as high as thought in patients who are followed up regularly and received colchicine.
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    The impact of COVID-19 on familial Mediterranean fever: a nationwide study
    (Springer Science and Business Media Deutschland GmbH, 2021) Günendi, Zafer; Yurdakul, Fatma Gül; Bodur, Hatice; Cengiz, Ahmet Kıvanç; Uçar, Ülkü Gürbüz; Çay, Hasan Fatih; Şen, Nesrin; Keskin, Yaşar; Gürer, Gülcan; Melikoǧlu, Meltem Alkan; Altıntaş, Duygu; Deveci, Hülya Mutlu; Baykul, Merve; Nas, Kemal; Çevik, Remzi; Karahan, Ali Yavuz; Toprak, Murat M.; Ketenci, Sertaç; Nayimoğlu, Mehmet; Sezer, İlhan; Demir, Ali Nail; Ecesoy, Hilal; Duruöz, Tuncay; Volkan Yurdakul, Ozan; Sarıfakıoğlu, Ayşe Banu; Ataman, Şebnem
    The study aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) in patients with familial Mediterranean fever (FMF) and to assess the relationships between FMF characteristics and severe COVID-19 outcomes such as hospitalization. The study was planned within a national network of 21 different centers. Demographics, FMF-related clinical and genetic characteristics, and COVID-19 outcomes were obtained. A total of 822 patients with FMF (mean age of 36 years) were included in the study. Fifty-nine of them (7%) had a COVID-19 diagnosis confirmed by real-time PCR test or chest CT findings. Most FMF patients with COVID-19 (58) had mild and moderate disease activity. All patients were on colchicine treatment. However, 8 of them (13.6%) were not compliant with colchicine use and 9 of them (15.3%) were colchicine resistant. Twelve FMF patients with COVID-19 were hospitalized. There were 4 patients requiring oxygen support. COVID-19 related complications were observed in 2 patients (1 thromboembolism, 1 acute respiratory distress syndrome). Hospitalized COVID-19 patients with FMF were older than non-hospitalized patients (median ages: 51 and 31 years, respectively; p: 0.002). Other FMF-related characteristics were similar between the groups. FMF-related characteristics were not found to be associated with poor outcomes in COVID-19. Thus, FMF may not be a risk factor for poor COVID-19 outcomes.