What is the role of biopsy in the diagnosis of familial Mediterranean fever (FMF)?

Updated: Apr 07, 2020
  • Author: John O Meyerhoff, MD; Chief Editor: Herbert S Diamond, MD  more...
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Amyloidosis can be presumed in patients with FMF, particularly those of North African descent who have proteinuria. Renal biopsy or, alternatively, submucosal rectal biopsy, is indicated in these patients.

A recent retrospective review of kidney biopsies in FMF patients found that 40% of the patients had nonamyloid kidney disease (NAKD). While the patients with amyloid kidney disease (AKD) had more proteinuria and more of them had more than 3.5 g of proteinuria, all of these biopsies were in patients with greater than 500 mg of proteinuria. The AKD patients had more severe disease and were more likely to have hypertension. All patients with proteinuria of greater than 500 mg/24 h should have a biopsy. [18]

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