Familial Mediterranean Fever

We read with interest Casey et al’s report on a New Zealand case of Familial Mediterranean Fever (FMF) published recently in the New Zealand Medical Journal (NZMJ).1 It is increasingly becoming evident that this disease, although only common in Middle East populations, should also be considered in every relevant clinical situation, everywhere in the world. Following cloning of the MEFV gene, it is expected that pyrin, the MEFV-coded protein that is mutated in FMF, will attract major interest in the years to come.2 Several independent groups have recently shown that the disease is considerably spread within many populations of the Mediterranean Basin—namely, Greeks, Cypriots, Italians, and Spanish.3–6 Some so-called phenotype II FMF cases (renal amyloidosis being the presenting symptom) are also increasingly reported from the same areas.3,7 The distribution of pyrin gene mutations is complex among highly affected populations (ie, Arabs-Jewish-Armenians-Turks); that is, a limited number of mutations (less than 5) account for the vast majority of cases—as opposed to populations non-highly affected by the disease where the 5 more common mutation