Vitamin B12 levels in patients with Familial Mediterranean Fever (FWF) under regular colchicine treatment

INTRODUCTION: Unremitting use of daily colchicine as a standard theurapeuticregimen for Familial Mediterranean Fever (FMF) warrants a decrease in frequencyand intensity of acute episodes in a majority of patients. It is denoted that regularintake of colchicine in appropriate dosage; not only prevents from amyloidosis todevelop, but also elicits a regression in renal involvement of amyloidosis; eventhough it is ineffective in the course of execarbetions. Initial articles blaming thecolchicine treatment as a causative agent for B12 insufficiency were published at60?s and 70?s. It is still debated that B12 replacement is required for patients underregular colchicine treatment. There is no recent data with large sample populationwhen improvements in biochemical kits detecting B12 vitamin levels are taken intoaccount. In this study we aimed to measure vitamin B12 levels in patients underregular colchicine treatment.MATERIALS AND METHOD: 95 FMFpatients with a close follow up by ouroutpatient clinics and a control group of 90 individuals sharing the same demographiccharacteristics were included in the study. Hemoglobin, folic acid, ferritin and B12vitamin levels of all individuals were measured and relationship of the obtained datawith regular colchicine intake was investigated.RESULTS: Mean vitamin B12 levels were measured as 352,12 ± 171,62 in thesample group and 360,96 ± 146,53 in the control group. No statistical significancebetween B12 vitamin levels of two groups were observed (p = 0,707). When twogroups were compared for vitamin B12 deficiency defined as serum level of 194pg/ml and below.; 12,6% of patients and 3,3% of control group was stated to bedeficient. Consequently; vitamin B12 deficiency was significantly higher in patientsunder regular colchicine treatment in comparison to the control group. Hemoglobin,haematocrit, folic acid and ferritin levels were similar both in sample and controlgroup.DISCUSSION: As a result of this study; long lasting and constant intake ofcolchicine may cause asymptomatic vitamin B12 deficiency and may lead to severeneuropsychiatric and haematological disorders if left untreated; we suggest tomeasure vitamin B12 levels in certain intervals. If a deficiency is determined becausecessation of colchicine is not reliable; replacement of vitamin B12 may beconsidered. Absence of investigations about this topic involving large patient seriesnecessitates further evaluation. Having the property of largest sample population inthe literature; distinguishes our study from others and hopefully inspire the largerones.Keywords: FMF, Vitamin B12, Colchicine