From the Research
There is a potential correlation between familial Mediterranean fever (FMF) and prostatitis, though the relationship is not fully established. FMF is an inherited autoinflammatory disorder characterized by recurrent episodes of fever and inflammation that can affect multiple organ systems, including the prostate gland. Some patients with FMF may experience prostatitis-like symptoms during flare-ups, including pelvic pain, urinary symptoms, and discomfort. The underlying mechanism likely involves the systemic inflammatory response in FMF, driven by mutations in the MEFV gene, which can trigger inflammation in various tissues including the prostate 1.
Key Considerations
- Colchicine, the standard treatment for FMF (typically dosed at 0.6-1.2 mg daily), may help prevent prostatitis symptoms in these patients by reducing overall inflammation 2.
- For patients with both conditions, managing the underlying FMF with appropriate colchicine dosing is essential, while acute prostatitis episodes might require additional treatment with appropriate antibiotics if bacterial infection is present.
- Patients with FMF who develop urinary symptoms should discuss these with their healthcare provider to determine if prostatitis is present and to adjust their treatment plan accordingly.
- In cases where colchicine is not effective, biologic agents such as TNF-blockers may be considered as an alternative treatment option for FMF patients with concurrent inflammatory diseases 3, 4.
Treatment Approach
- The primary goal is to manage the underlying FMF with colchicine and adjust the treatment plan as needed to address prostatitis symptoms.
- Monitoring for proteinuria every 6 months is recommended for patients with FMF, especially those with the p.Met694Val mutation, to prevent renal amyloidosis 1.
- Patients should be aware of the potential for prostatitis-like symptoms during FMF flare-ups and seek medical attention if they experience pelvic pain, urinary symptoms, or discomfort.
Future Directions
- Further research is needed to fully establish the correlation between FMF and prostatitis and to determine the most effective treatment approaches for patients with both conditions.
- Studies investigating the use of biologic agents in FMF patients with prostatitis may provide valuable insights into alternative treatment options 3, 4.