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Familial Mediterranean fever — SCE Rheumatology MCQ

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HardPregnancy in rheumatic disease and rare conditionsFamilial Mediterranean feverSCE Rheumatology

A patient with familial Mediterranean fever is clinically well on colchicine. Which surveillance measure most directly detects early renal AA amyloid disease?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Serial urine ACR and estimated glomerular filtration rate

Persistent albuminuria or proteinuria may be the first sign of renal AA amyloidosis in FMF. Urinary protein quantification and renal function should be followed even when attacks are controlled, alongside inflammatory control and adherence assessment.

Reference: EULAR/PReS recommendations for familial Mediterranean fever — 2024 update (Published April 2025): https://ard.bmj.com/content/84/6/899; NICE NG203: chronic kidney disease — assessment and management (Updated November 2021): https://www.nice.org.uk/guidance/ng203/chapter/Recommendations