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MEFV gene mutations spectrum among Lebanese patients referred for Familial Mediterranean Fever work-up: Experience of a major tertiary care center

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Abstract

Familial Mediterranean Fever (FMF) is an autosomal recessive inflammatory disorder predominantly affecting people living in or originating from areas around the Mediterranean Sea, mainly Jews, Armenians, Turks, and Arabs. It is characterized by recurrent attacks of inflammation of serosal membranes and fever resulting in acute abdominal, chest, or joint pain. Over 50 MEditerranean FeVer (MEFV) mutations and polymorphisms have been identified in FMF patients. The objective of this study was to analyze the distribution and frequencies of 12 MEFV mutations in 266 referred Lebanese patients using a reverse-hybridization assay. Of the 266 patients, 129 (48.5%) were positive for at least one mutation and 137 (51.5%) had no mutations detected. Of the 129 patients with mutations, 35 were homozygous, 41 were compound heterozygous and 53 were heterozygous. The five most common mutations M694V, E148Q, V726A, M694I and M680I (G/C) accounted for 26.1, 22.2, 21.3, 9.6 and 7.7%, respectively. The A744S, F479L, R761H and I692del were encountered in 2.9% of patients; P369S and M680I (G/A) were found in 1.2% of patients while K695R was absent. The spectrum of the MEFV mutations among our sampled Lebanese FMF patients shows the high heterogeneity at the allelic level when compared to Arab and non-Arab populations. The most important feature was the relatively high frequency of the E148Q in our study group that allows us to question it as a mutation rather than a polymorphism. Further studies should be conducted to evaluate the role of the E148Q allele.

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References

  1. Sohar E, Gafni J, Pras M, Heller H (1967) Familial Mediterranean fever. A survey of 470 cases and review of the literature. Am J Med 43:227–253

    Article  PubMed  CAS  Google Scholar 

  2. Touitou I, Ben-Chetrit E, Notrnicola C, Domingo C, Dewalle M, Dross C et al (1998) Familial Mediterranean fever clinical and genetic features in druzes and in Iraqi jews: a preliminary study. J Rhumatol 25:916–919

    CAS  Google Scholar 

  3. Daniels M, Shohat T, Brenner-Ullman A, Shohat M (1995) Familial Mediterranean fever: high gene frequency among the non-Ashkenazic and Ashkenazic jewish populations in Israel. Am J Med Genet 55:311–314

    Article  PubMed  CAS  Google Scholar 

  4. Chen X, Fischel-Ghodsian N, Cercek A, Hamon M, Ogur G, Lotan R et al (1998) Assessment of Pyrin gene mutations in Turks with familial Mediterranean fever (FMF). Hum Mutat 11:456–460

    Article  PubMed  Google Scholar 

  5. Pras E, Aksentijevich I, Gruberg L, Balow JE Jr, Prosen L, Dean M et al (1992) Mapping of a gene causing familial Mediterranean fever to the short arm of chromosome 16. N Engl J Med 326:1509–1513

    PubMed  CAS  Google Scholar 

  6. The French FMF consortium (1997) A candidate gene for familial Mediterranean fever. Nat Genet 17:25–31

    Article  Google Scholar 

  7. The International FMF consortium (1997) Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever. Cell 90:797–807

    Article  Google Scholar 

  8. Mansfield E, Chae JJ, Komarow HD, Brotz TM, Frucht DM, Aksentijevich I et al (2001) The familial Mediterranean fever protein, Pyrin, associates with microtubules and colocalizes with actin filaments. Blood 98:851–859

    Article  PubMed  CAS  Google Scholar 

  9. Papin S, Cuenin S, Agostini L, Martinon F, Werner S, Beer HD et al (2007) The SPRY domain of Pyrin, mutated in familial Mediterranean fever patients, interacts with inflammasome components and inhibits proIL-1beta processing. Cell Death Differ; April 13 [Epub ahead of print]

  10. INFEVERS. The registry of Familial Mediterranean Fever (FMF) and Hereditary Autoinflammatory Disorders Mutations. http://fmf.igh.cnrs.fr/ISSAID/infevers/

  11. Touitou I, Lesage S, McDermott M, Cuisset L, Hoffman H, Dode C et al (2004) An evolving mutation database for auto-inflammatory syndromes. Hum Mutat 24:194–198

    Article  PubMed  CAS  Google Scholar 

  12. Booth DR, Gillmore JD, Booth SE, Pepys MB, Hawkins PN (1998) Pyrin/marenostrin mutations in familial Mediterranean fever. Q J Med 91:603–606

    CAS  Google Scholar 

  13. Oberkanins C, Moritz A, de Villiers JN, Kotze MJ, Kury F (2000) A reverse-hybridization assay for the rapid and simultaneous detection of nine HFE gene mutations. Genet Test 4:121–124

    Article  PubMed  CAS  Google Scholar 

  14. Kriegshauser G, Weinhause A, Haas OA, Kuru F, Oberkanins C (2002) Molecular genetic diagnosis of familial Mediterranean fever by PCR and reverse-hybridization. Clin Exp Rheumatol 20:86

    Google Scholar 

  15. Al-Alami JR, Tayeh MK, Najib DA, Abu-Rubaiha ZA, Majeed HA, Al-Khateeb MS et al (2003) Familial Mediterranean fever mutation frequencies and carrier rates among a mixed Arabic population. Saudi Med J 24:1055–1059

    PubMed  Google Scholar 

  16. Brik R, Shinawi M, Kepten I, Berant M, Gershoni-Baruch R (1999) Familial Mediterranean fever: clinical and genetic characterization in a mixed pediatric population of Jewish and Arab patients. Pediatrics 103:70

    Article  Google Scholar 

  17. Majeed HA, El-Shanti H, Al-Khateeb MS, Rabaiha ZA (2002) Genotype/phenotype correlations in Arab patients with familial Mediterranean fever. Semin Arthritis Rheum 31:71–76

    Article  Google Scholar 

  18. Mansour I, Delague V, Cazeneuve C, Dode C, Chouery E, Pecheux C et al (2001) Familial Mediterranean fever in Lebanon: mutation spectrum, evidence for cases in Maronites, Greek orthodoxes, Greek catholics, Syriacs and Chiites and for an association between amyloidosis and M694V and M694I mutations. Eur J Hum Genet 9:51–55

    Article  PubMed  CAS  Google Scholar 

  19. Majeed HA, El-Khateeb M, El-Shanti H, Abu Rabaiha Z, Tayeh M, Najib D (2005) The spectrum of familial Mediterranean fever gene mutations in arabs: report of a large series. Semin Arthritis Rheum 34:813–818

    Article  PubMed  CAS  Google Scholar 

  20. Ayesh SK, Nassar SM, Al-Sharef WA, Abu-Libdeh BY, Darwish HM (2005) Genetic screening of familial Mediterranean fever mutations in the Palestinian population. Saudi Med J 26:732–737

    PubMed  Google Scholar 

  21. Dode C, Pecheux C, Cazeneuve C, Cattan D, Dervichian M, Goossens M et al (2000) Mutations in the MEFV gene in a large series of patients with a clinical diagnosis of familial Mediterranean fever. Am J Med Genet 92:241–246

    Article  PubMed  CAS  Google Scholar 

  22. Gershoni-Baruch R, Brik R, Shinawi M, Livneh A (2002) The differential contribution of MEFV mutant alleles to the clinical profile of familial Mediterranean fever. Eur J Hum Genet 10:145–149

    Article  PubMed  CAS  Google Scholar 

  23. Medlej-Hashim M, Rawashdeh M, Chouery E, Mansour I, Delague V, Lefranc G et al (2000) Genetic screening of fourteen mutations in Jordanian familial Mediterranean fever patients. Hum Mutat 15:384

    Article  PubMed  CAS  Google Scholar 

  24. Touitou I (2001) The spectrum of familial Mediterranean fever (FMF) mutations. Eur J Hum Genet 9:473–483

    Article  PubMed  CAS  Google Scholar 

  25. Mattit H, Joma M, Al-Cheikh S, El-Khateeb M, Medlej-Hashim M, Salem N et al (2006) Familial Mediterranean fever in the Syrian population: gene mutation frequencies, carrier rates and phenotype–genotype correlation. Eur J Med Genet 49:481–486

    Article  PubMed  Google Scholar 

  26. Yalcinkaya F, Cakar N, Misirlioglu M, Tumer N, Akar N, Tekin M et al (2000) Genotype–phenotype correlation in a large group of Turkish patients with familial mediterranean fever: evidence for mutation-independent amyloidosis. Rheumatology (Oxford) 39:67–72

    Article  CAS  Google Scholar 

  27. Cazeneuve C, Sarkisian T, Pecheux C, Dervichian M, Nedelec B, Reinert P et al (1999) MEFV-gene analysis in armenian patients with familial Mediterranean fever: diagnostic value and unfavorable renal prognosis of the M694V homozygous genotype-genetic and therapeutic implications. Am J Hum Genet 65:88–97

    Article  PubMed  CAS  Google Scholar 

  28. Padeh S, Shinar Y, Pras E, Zemer D, Langevitz P, Pras M et al (2003) Clinical and diagnostic value of genetic testing in 216 Israeli children with familial Mediterranean fever. J Rheumatol 30:185–190

    PubMed  Google Scholar 

  29. Gershoni-Baruch R, Shinawi M, Leah K, Badarnah K, Brik R (2001) Familial Mediterranean fever: prevalence, penetrance and genetic drift. Eur J Hum Genet 9:634–637

    Article  PubMed  CAS  Google Scholar 

  30. Ben-Chetrit E, Lerer I, Malamud E, Domingo C, Abeliovich D (2000) The E148Q mutation in the MEFV gene: is it a disease-causing mutation or a sequence variant? Hum Mutat 15:385–386

    Article  PubMed  CAS  Google Scholar 

  31. Tchernitchko D, Legendre M, Cazeneuve C, Delahaye A, Niel F, Amselem S (2003) The E148Q MEFV allele is not implicated in the development of familial Mediterranean fever. Hum Mutat 22:339–340

    Article  PubMed  Google Scholar 

  32. Bernot A, da Silva C, Petit JL, Cruaud C, Caloustian C, Castet V et al (1998) Non-founder mutations in the MEFV gene establish this gene as the cause of familial Mediterranean fever (FMF). Hum Mol Genet 7:1317–1325

    Article  PubMed  CAS  Google Scholar 

  33. Medlej-Hashim M, Serre JL, Corbani S, Saab O, Jalkh N, Delague V et al (2005) Familial Mediterranean fever (FMF) in Lebanon and Jordan: a population genetics study and report of three novel mutations. Eur J Med Genet 48:412–420

    Article  PubMed  Google Scholar 

  34. Samuels J, Aksentijevich I, Torosyan Y, Centola M, Deng Z, Sood R et al (1998) Familial Mediterranean fever at the millennium: clinical spectrum, ancient mutations, and a survey of 100 American referrals to the National Institutes of Health. Medicine (Baltimore) 77:268–297

    Article  CAS  Google Scholar 

  35. Aksentijevich I, Torosyan Y, Samuels J, Centola M, Pras E, Chae JJ et al (1999) Mutation and haplotype studies of familial Mediterranean fever reveal new ancestral relationships and evidence for a high carrier frequency with reduced penetrance in the Ashkenazi Jewish population. Am J Hum Genet 64:949–962

    Article  PubMed  CAS  Google Scholar 

  36. Medlej-Hashim M, Loiselet J, Lefranc G, Megarbane A (2004) Familial Mediterranean fever (FMF): from diagnosis to treatment. Sante 14:261–266

    PubMed  Google Scholar 

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Correspondence to Rami A. R. Mahfouz.

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Sabbagh, A.S., Ghasham, M., Abdel Khalek, R. et al. MEFV gene mutations spectrum among Lebanese patients referred for Familial Mediterranean Fever work-up: Experience of a major tertiary care center. Mol Biol Rep 35, 447–451 (2008). https://doi.org/10.1007/s11033-007-9105-3

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  • DOI: https://doi.org/10.1007/s11033-007-9105-3

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