Thoracic and lung involvement in familial Mediterranean fever (FMF).

Lung involvement in FMF is limited mainly to transient pleuritis during acute attacks. Amyloidosis of the lung is rare and is associated with symptomatic involvement of other organs while remaining subclinical in itself. Vasculitis of the lung in FMF is possible because of the strong association between FMF and a variety of vasculitides. With the exception of one case of isolated pulmonary vasculitis, vasculitis of the lung in FMF has not been described. The claim that FMF protects against asthma has not been established, but this inverse association, if present, may be traced to linkage disequilibrium in which MEFV modifies the effect of asthma and atopic-related genes, or to eosinophil function. Mesothelioma has been reported in at least four patients with FMF and is related to chronic or recurrent stimulation of the serous membrane. Three patients had peritoneal mesothelioma, while one developed mesothelioma of the lung. Finally, thromboembolism should be considered, particularly in patients with FMF amyloidosis who present with respiratory distress.