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    The evaluation of the role of mycobacterium Tuberculosis in the etiopathogenesis of Familial Mediterranean Fever
    (1999) Akcan, Yusuf; Tuncer, Serdar; Ünal, Serhat; Sökmensüer, Cenk; Haznedaroğlu, Celalettin İbrahim; Arslan, Serap
    Tuberculosis (TB) and familial Mediterranean fever (FMF) are two common diseases in our region, Turkey. Both share some properties in common such that both cause AA type amyloidosis and have association with some immunological abnormalities. Upon incidentally observing M. tuberculosis in bone marrow biopsies of three patients with FMF in a previous study, we intended to elucidate this association prospectively. In this preliminary study, we examined 10 FMF patients, 5 male and 5 female, with a median duration of 17 years disease activity. All were under colchicine therapy. They had no sign of renal involvement. The bone marrow biopsies of these patients were examined for the presence of M. tuberculosis by polymerase chain reaction, BACTEC cul¬ture and pathological stains. Pathological examination was performed for the existence of granuloma and amyloid deposition by hematoxilen-eosine, crystal violet and Congo red stains. Negative results were obtained in all specimens examined with all these mentioned methods. The patients had a positive family history of 60% for tuberculosis and in 80% of them with positive tuberculin skin test. We concluded that although there seemed to be a kind of association between both diseases, this relationship is not via the direct existence of bacteria itself. Considering high family history and skin test positivity, one should look for the presence of autoimmune mechanisms under this suspicious relationship between tuberculosis and FMF. Additionally, this became the first study examined the state of amyloidosis in the bone marrow at an earlier stage of FMF without overt renal findings.