The effect of tonsillectomy on clinical manifestations in Familial Mediterranean fever.

Purpose: Familial Mediterranean fever (FMF) is the most prevalent genetic autoinflammatory disease worldwide. There are several novel advancements in pathophysiology, genetic testing, diagnosis, comorbidities, disease-related damage, and treatment strategies. This study aimed to assess the effect of tonsillectomy on FMF disease severity and activity.

Methods: This prospective randomized cohort study was conducted on 43 patients diagnosed with FMF and chronic tonsillitis, who were divided randomly into two groups: Group I, a case group including 23 patients subjected to tonsillectomy and medical treatment using colchicine; Group II, a control group consisting of 20 cases receiving only colchicine. The monthly frequency of the attacks and average duration of the three symptoms, such as fever, abdominal/chest pain, and musculoskeletal pain in days, were evaluated and recorded.

Results: A highly significant reduction in the monthly frequency of attacks, duration of fever, abdominal/chest pain, and musculoskeletal pain was observed three months after management in both study groups (p < 0.00001 for all). Evaluation of the values of both groups revealed a significant increase in the degree of change for the duration of fever, abdominal/chest pain in Group I relative to Group II (p = 0.0003 and 0.006 respectively) and a significant increase in the degree of change for musculoskeletal pain in Group II relative to Group I (p = 0.007). Survival analysis showed a nonsignificant difference between the two groups regarding the resolution of fever, abdominal/chest pain, and musculoskeletal pain at 12, 18, and 24 months (p = 0.26, 0.08, and 0.42, respectively) CONCLUSION: Tonsillectomy operation combined with colchicine resulted in a greater but nonsignificant decrease in the monthly frequency of the FMF attacks and a significant greater decrease in the duration of fever and abdominal/chest pain compared with the use of colchicine alone. Further research is recommended to confirm these results on a larger scale.