Small Intestinal Bacterial Overgrowth Affects the Responsiveness to Colchicine in Familial Mediterranean Fever
Objective. Familial Mediterranean fever (FMF) is an autosomal recessive disease due to a MEFV gene mutation. Since Helicobacter pylori infection has been described to increase the severity and frequency of FMF attacks, we evaluate if overgrowth of small intestinal bacterial (SIBO), associated with a...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2017/7461426 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850166975708266496 |
|---|---|
| author | E. Verrecchia L. L. Sicignano M. La Regina G. Nucera I. Patisso L. Cerrito M. Montalto A. Gasbarrini R. Manna |
| author_facet | E. Verrecchia L. L. Sicignano M. La Regina G. Nucera I. Patisso L. Cerrito M. Montalto A. Gasbarrini R. Manna |
| author_sort | E. Verrecchia |
| collection | DOAJ |
| description | Objective. Familial Mediterranean fever (FMF) is an autosomal recessive disease due to a MEFV gene mutation. Since Helicobacter pylori infection has been described to increase the severity and frequency of FMF attacks, we evaluate if overgrowth of small intestinal bacterial (SIBO), associated with a release of bacterial products, can affect the response to colchicine in FMF patients poorly responsive to colchicine. Methods. We revised our Periodic Fever Centre database to detect FMF patients who were poorly responsive to colchicine, without a well-defined cause of drug resistance. They were evaluated for SIBO presence, then treated with decontamination therapy. Results. Among 223 FMF patients, 49 subjects show colchicine resistance, and no other known causes of colchicine unresponsiveness has been found in 25 patients. All 25 patients underwent glucose breath test; 20 (80%) of them were positive, thus affected by SIBO. After a successful decontamination treatment, 11 patients (55%) did not show FMF attacks during the following three months (p<0.01), while 9 of them revealed a significant reduction of the number of attacks compared to three months before (p<0.01). Conclusion. The SIBO eradication improves laboratory and clinical features of FMF patients. Thus, patients with unresponsiveness to colchicine treatment should be investigated for SIBO. |
| format | Article |
| id | doaj-art-e4d6c35821dd4661bce648823e64821b |
| institution | OA Journals |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-e4d6c35821dd4661bce648823e64821b2025-08-20T02:21:18ZengWileyMediators of Inflammation0962-93511466-18612017-01-01201710.1155/2017/74614267461426Small Intestinal Bacterial Overgrowth Affects the Responsiveness to Colchicine in Familial Mediterranean FeverE. Verrecchia0L. L. Sicignano1M. La Regina2G. Nucera3I. Patisso4L. Cerrito5M. Montalto6A. Gasbarrini7R. Manna8Periodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyPeriodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyPeriodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyPeriodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyPeriodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyPeriodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyPeriodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyPeriodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyPeriodic Fever Research Centre, Department of Internal Medicine, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, ItalyObjective. Familial Mediterranean fever (FMF) is an autosomal recessive disease due to a MEFV gene mutation. Since Helicobacter pylori infection has been described to increase the severity and frequency of FMF attacks, we evaluate if overgrowth of small intestinal bacterial (SIBO), associated with a release of bacterial products, can affect the response to colchicine in FMF patients poorly responsive to colchicine. Methods. We revised our Periodic Fever Centre database to detect FMF patients who were poorly responsive to colchicine, without a well-defined cause of drug resistance. They were evaluated for SIBO presence, then treated with decontamination therapy. Results. Among 223 FMF patients, 49 subjects show colchicine resistance, and no other known causes of colchicine unresponsiveness has been found in 25 patients. All 25 patients underwent glucose breath test; 20 (80%) of them were positive, thus affected by SIBO. After a successful decontamination treatment, 11 patients (55%) did not show FMF attacks during the following three months (p<0.01), while 9 of them revealed a significant reduction of the number of attacks compared to three months before (p<0.01). Conclusion. The SIBO eradication improves laboratory and clinical features of FMF patients. Thus, patients with unresponsiveness to colchicine treatment should be investigated for SIBO.http://dx.doi.org/10.1155/2017/7461426 |
| spellingShingle | E. Verrecchia L. L. Sicignano M. La Regina G. Nucera I. Patisso L. Cerrito M. Montalto A. Gasbarrini R. Manna Small Intestinal Bacterial Overgrowth Affects the Responsiveness to Colchicine in Familial Mediterranean Fever Mediators of Inflammation |
| title | Small Intestinal Bacterial Overgrowth Affects the Responsiveness to Colchicine in Familial Mediterranean Fever |
| title_full | Small Intestinal Bacterial Overgrowth Affects the Responsiveness to Colchicine in Familial Mediterranean Fever |
| title_fullStr | Small Intestinal Bacterial Overgrowth Affects the Responsiveness to Colchicine in Familial Mediterranean Fever |
| title_full_unstemmed | Small Intestinal Bacterial Overgrowth Affects the Responsiveness to Colchicine in Familial Mediterranean Fever |
| title_short | Small Intestinal Bacterial Overgrowth Affects the Responsiveness to Colchicine in Familial Mediterranean Fever |
| title_sort | small intestinal bacterial overgrowth affects the responsiveness to colchicine in familial mediterranean fever |
| url | http://dx.doi.org/10.1155/2017/7461426 |
| work_keys_str_mv | AT everrecchia smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever AT llsicignano smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever AT mlaregina smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever AT gnucera smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever AT ipatisso smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever AT lcerrito smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever AT mmontalto smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever AT agasbarrini smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever AT rmanna smallintestinalbacterialovergrowthaffectstheresponsivenesstocolchicineinfamilialmediterraneanfever |