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The country of residence affects the phenotype of familial Mediterranean fever: is it real or a selection bias?
  1. Cengiz Korkmaz
  1. Correspondence to Professor Cengiz Korkmaz, Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Meselik Campus, Eskişehir 26480, Turkey; ckorkmaz{at}

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I read with great interest the article by Ozen et al1 who reported that the country of residence may play a role on the expression of familial Mediterranean fever (FMF) in children. They have compared the severity of this disease in three groups, including patients living in Eastern Mediterranean countries (Group A), as well as those living in Western Europe but of Eastern Mediterranean ancestry (Group B), and patients of Caucasian origin living in Western European countries (Group C). The authors have modified the already existing severity scores determined for child patients with FMF. Their modified childhood severity score includes the frequency of attacks, presence of chest pain, acute or protracted arthritis, presence of abdominal pain, failure of complete response to an …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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