Treatment of Crohn’s disease and familial Mediterranean fever by leukopheresis: Single shot for two targets

Abstract

Coexistence of Crohn's disease (CD) and familial Mediterranean fever (FMF) is a rare condition and knowledge about this clinical situation is limited with a few case reports in the literature. The treatment of both diseases depends on their individual therapies. However, it is very hard to deal with this coexistence when CD is refractory to standard therapies. Ongoing activity of CD triggers the clinical attacks of FMF and the symptoms like abdominal pain interfere with both disease presentations which can cause problems about diagnostic and therapeutic approach. The main therapeutic agent for FMF is colchicine and diarrhea is the most common side effect of this drug. This side effect also causes problems about management of these diseases when both of them are clinically active. Here we report probably the first case in the literature with coexisting CD and FMF who was successfully treated by leukopheresis since he was refractory to conventional therapies for CD.

Keywords: Crohn’s disease; Familial Mediterranean fever; Leukopheresis

Core tip: Management of coexisting autoimmune diseases is sometimes problematic because of resistance to standard therapies. Coexistence of Crohn’s disease and familial Mediterranean fever is a rare condition, so the experience about their treatment is lacking. In our report we are sharing our treatment experience of a patient with this coexistence, where the case is refractory to conservative therapies and apheresis was applied as the last choice of treatment. This treatment modality seems to be the first in the literature for these diseases.