Historical View

edited by H. Yazici

The other physician behind the use of colchicine for the

1
Division of Rheumatology, Department One of , if not the most, quoted papers
of Medicine, Istanbul Medical Faculty, in FMF is the seminal article by Sohar,
University of Istanbul, 2Division of Gafni, Pras and Heller in the American
Rheumatology, Department of Medicine,
Journal of Medicine in 1967 (1). This
Cerrahpasa Medical Faculty, University
of Istanbul, Turkey. paper, based on the authors’meticulous
clinical observations on nearly 500
Please address correspondence and reprint
requests to: Prof. Hasan Yazici, Safa sok. patients with familial Mediterranean
17/7 Kadikoy, Istanbul 81310, Turkey. fever (FMF) has, over the last four
E-mail: hyazici@[Link] decades, been a most valuable source
Clin Exp Rheumatol 2001: 19 (Suppl. 24): of reference for both clinicians and sci-
S13-S14. entists. In the Sohar article one finds
© Copyright CLINICAL AND not only very useful information on the
EXPERIMENTAL RHEUMATOLOGY 2001. myriad of clinical presentations of
FMF but also gets introduced to some
Key words: Colchicine, FMF. notable and far-reaching views on the
pathogenesis and genetics, including
the recently revisited concept of auto- Fig. 1. Prof. Emir Özkan.
somal dominant transmission. Howev-
er, there is one, from the standpoint if in the small percentage of patients
the medical historian, rather interesting among whom the attack preventing ef-
note in this article. In the section devot- fect of colchicine is not that pronounc-
ed to the treatment the authors first ed. There is little doubt that we and our
quote a long list of remedies reported to patients owe a lot to Dr. Goldfinger.
be not useful and then continue with However, what is not widely known
their own experience with both IV and about this wonderful colchicine-FMF
oral colchicine and say that this drug is story is the contribution of another phy-
of no help in FMF, either. sician from a part of the globe as far
In l972 Dr. Goldfinger of the Massa- from Boston as the Eastern end of the
chusetts Hospital in Boston publishes Mediterranean sea from the western
perhaps one the most famous letters to end of the Atlantic Ocean. Dr. Emir
the editor ever in the New England Özkan (Fig 1), a professor of Medicine
Journal of Medicine (2). His letter in the Department of Cardiology in the
“Colchicine for Familial Mediterrane- Medical Faculty of University of Istan-
an Fever” describes five patients with bul is from Sivas, a town in Mid East-
FMF all prescribed colchicine and all ern Anatolia not only the heartland of
of whom make a remarkable recovery Turkey but also epidemiologically the
from their illness once this age-old heartland of FMF (3). As a physician of
medicine is prescribed. Everybody Anatolian background he feels respon-
even remotely familiar with medicine sible not only to patients with cardio-
and most importantly the FMF patients logical problems, his main line of
and their families now know that this work, but he cannot turn down also the
time honoured gout-drug is the remedy substantial number of patients from his
for FMF. It not only stops the very homeland that come with other com-
debilitating attacks of serositis but also plaints to seek the help of their native
prevents the emergence of amyloidosis, who has made the megapolis. Among
the most dreaded complication. This these patients, as expected, there is a
latter effect seems also to be true even substantial number with FMF and Dr.

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EDITORIAL History of colchicine in FMF / O. Aral et al.

Özkan, along with several of his col- ance of proteinuria after 6 months of FMF. Another award, named after H.
leagues apparently prescribe colchicine treatment. Heller, was given to that person that
and salicylamide to these patients with During the Second International Con- had contributed most to the “basic sci -
remarkable good outcome. They go on gress on Familial Mediterranean Fever ence” of FMF, was received by Dr. Isa -
to publish their findings on the treat- in Antalya in May 2000, the organizers belle Touitou for her original and con -
ment of FMF in an article entitled “A felt that a tribute must also be paid to tinuing contribution to the discovery of
New Approach to the Treatment of Pe- Dr. Emir Özkan. In fact during the clos- the genetics of FMF. Dr. Daniel Kast -
riodic Fever” in the December 1972 ing ceremonies an award called the ner had been the recipient of the first
issue of the Medical Bulletin of Istan- “Goldfinger-Özkan award” was given “Heller award” given during the First
bul Medical Faculty (Fig. 2) (4). From to that person who contributed most si- International Congress on Familial
the note on the first page we understand gnificantly to the “clinical science and Mediterranean Fever, held in Jeru -
that the authors submitted this article management” of FMF.* The first salem in 1997.
on April 17, 1972, some 8 months be- Goldfinger-Özkan award went to Dr.
fore the appearance of the Goldfinger Mehmet Tunca for his work in the References
article in the New England Journal of acute phase response and interferon 1. SOHAR E, GAFNI J, PRAS M, HELLER H: Fa-
milial Mediterranean fever: a survey of 470
Medicine which appears in the same treatment of FMF. Prof. Özkan died in cases and review ofthe literature. Am J Med
month (December 2lst issue) of the a sea accident in 1987. His wife had 1967; 43: 227-53.
said journal. already passed away and they had no 2. GOLDFINGERSE: Colchicine for familial Me-
In short Özkan and colleagues report children. We all feel that the Goldfin- diterranean fever. N Eng J Med 1972; 287:
1302.
their very favorable experience with the ger-Özkan award has been and will 3. YAZICI H, OZDOGAN H: Familial Mediter-
combination of colchicine (0.025 mg/ continue to be a humble tribute to this ranean fever in Turkey. In: SOHAR E,GAFNI J,
kg/day) and salicylamide (20 mg/kg/ very fine and innovative physician- PRAS M (Eds.): Familial Mediterranean Fever.
day) in 14 patients with FMF. Of inter- teacher. London, Freund Publishing House Ltd., 1997:
66-71.
est is the fact that one of their patients *In fact during the closing ceremonies 4. ÖZKAN E, OKUR Ö, EKMEKÇI A, ÖZCAN R,
with renal amyloidosis and nephrotic two separate awards were given to the TAG T: A new approach to the treatment of pe-
syndrome had a complete disappear- distinguished and dedicated students of riodic fever. Med Bull Istanbul 1972; 5: 44-9.

Fig. 2. The paper by Prof. Emir Özkan reporting on the successful treatment of FMF with colchicine published in the December 1972 issue of the Medical
Bulletin of Istanbul Medical Faculty (reproduced with permission from Medical Bulletin of Istanbul Medical Faculty).

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