Development of focal segmental glomerulosclerosis in a patient with Familial Mediterranean Fever resistant to colchicine therapy under treatment with Canakinumab

Introduction Familial Mediterranean Fever (FMF) represents an autoinflammatory disease caused be MEFV gene mutation characterized with attacks of polyserositis, commonly seen among Turks, Arabs, Armenians and Jews. Therapy with colchicine was proven to be effective in treatment of FMF polyserositis and in prevention of amyloidosis development. Colchicine resistant FMF is defined as 6 or more attacks of polyserositis in a year, despite the regular and sufficient usage of colchicine. The percentage of resistant FMF has been reported as a 5-10% in the literature. Although colchicine remains the gold standard for the FMF treatment, anti-IL-1 drugs are used in the cases of FMF resistant to colchicine therapy. Particularly carriers of the M694V homozygous mutation prone to be resistant to standard therapy and show a risk for development of additional diseases.