Familial Mediterranean Fever: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Familial Mediterranean Fever?
A rheumatologist, a joint and inflammation doctor, usually treats FMF (familial Mediterranean fever). Children may see a pediatric rheumatologist. A nephrologist, a kidney doctor, may help if the kidneys are affected. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is familial Mediterranean fever?
Familial Mediterranean fever (FMF) is an inherited condition. It causes repeated attacks of painful inflammation in the belly, chest, or joints. These episodes are often accompanied by fever and sometimes a rash or headache.
FMF mainly affects people from the Mediterranean region. This includes people of Armenian, Arab, Turkish, or Jewish ancestry. It affects 1 in 200 to 1,000 people in these groups.
Symptoms
The first attack usually happens in childhood or the teen years, but sometimes it comes much later in life. Attacks typically last 12 to 72 hours. Between attacks, people usually have no symptoms. In about half of people, mild warning signs come before an attack. Symptoms can include:
- Fever.
- Belly pain or tenderness, from mild bloating to inflammation of the lining of the belly.
- Joint pain and swelling, most often in a knee, ankle, or hip.
- Chest pain from inflammation of the lining of the lungs, with painful breathing.
- Painful, swollen, bright red skin patches on the lower legs.
- Less often, inflammation around the heart or around the brain and spinal cord, which can cause headaches.
Without treatment, protein deposits called amyloidosis can build up in the body. It can happen especially in the kidneys, which can lead to kidney failure. Some people are wrongly thought to have a sudden belly problem and get surgery they do not need.
Causes and who gets it
FMF is caused by changes in the MEFV gene. This gene makes a protein called pyrin, which is found in white blood cells and helps control inflammation. Gene changes reduce how well pyrin works. Then inflammation is not well controlled.
FMF is usually inherited in an autosomal recessive pattern, which means both copies of the MEFV gene have changes. The parents each carry one copy of the changed gene but typically do not show signs of the condition. Some people with only one changed copy still have symptoms very similar to FMF. Attacks can sometimes be triggered by infection, injury, hard exercise, or stress. In women, the start of a period can trigger an attack.
How doctors diagnose it
Doctors look at typical symptoms and a detailed history. They also do an exam and specialized tests. Finding it early helps doctors avoid a wrong diagnosis and surgery you do not need. During an attack, blood tests may show signs of inflammation, such as a high sedimentation rate or high C-reactive protein. These tests are only useful during an attack and return to normal or near normal when it ends. Genetic testing for MEFV gene changes can confirm the diagnosis.
Treatment
There is no cure for FMF, but there are effective treatments. Many people take colchicine, the main medicine. It lowers inflammation. More than 90% of people who take it improve a lot in how long and how often attacks happen. Colchicine also helps prevent amyloid buildup in the kidneys. It must be taken every day, and it does not treat an attack once it has started.
Pain medicines and anti-inflammatory drugs called NSAIDs can be used during an attack. In 2016, the FDA approved canakinumab, a medicine that blocks interleukin-1, to treat FMF. Genetic counseling is advised for patients and their families.
When to see a doctor
See a doctor if you or your child has repeated fevers with belly pain, joint pain or swelling, or red patches on the lower legs. Call 911 or go to the emergency room if you have chest pain or discomfort lasting two minutes or more. Also call 911 or go to the emergency room for severe belly pain or pressure, severe trouble breathing, or fainting.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can review your symptoms, order first tests, help plan specialist visits, and follow long-term care.
Common questions
Can familial Mediterranean fever be cured?
No, there is no cure for FMF, but there are effective treatments. Colchicine is the main medicine.
How long does a familial Mediterranean fever attack last?
Attacks typically last 12 to 72 hours. The time between attacks can range from days to years.
Can familial Mediterranean fever harm the kidneys?
Yes, it can. Without treatment, protein deposits called amyloid can build up in the kidneys. This can lead to kidney failure. Colchicine helps prevent this buildup.
Who gets familial Mediterranean fever?
It mainly affects people whose families come from the Mediterranean region. This includes people of Armenian, Arab, Turkish, or Jewish ancestry.
Sources
- National Organization for Rare Disorders - Familial Mediterranean Fever
- MedlinePlus Genetics - Familial Mediterranean fever
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
