Characterizing MEFV gene variants in Jordanian patients with Familial Mediterranean Fever

BACKGROUND: Familial Mediterranean Fever (FMF) is inherited as an autosomal recessive autoinflammatory disorder caused by mutations in the Mediterranean fever (MEFV) gene and predominantly affects populations from the Mediterranean region. Despite its clinical significance, data regarding the genetic profile of FMF in Jordan remain limited. This study aimed to determine the frequency and pattern of commonly screened MEFV gene variants in a cohort of Jordanian patients clinically diagnosed with Familial Mediterranean Fever. METHODS: A retrospective study was conducted on 366 patients aged 12-18 years who fulfilled the Turkish clinical diagnostic criteria for FMF and were treated at Prince Hamza Hospital between October 2022 and December 2023. The Diagnosis was supported by laboratory investigations and inflammatory markers, followed by genetic screening for most common mutations for the MEFV gene. Ethical approval was obtained, and informed consent was provided by legal guardians. Genetic and clinical data were analyzed using SPSS version 23 and the R Studio program. RESULTS: Out of 366 individuals tested for MEFV gene mutations, 195 (53.3%) were mutation-positive and met the clinical criteria for FMF. The cohort comprised 75% males and 25% females, with a mean age of 13 ± 3 years and a mean age at symptom onset of 11 ± 4 years. The most frequently identified mutation was E148Q (25.12%), predominantly in the heterozygous state, followed by V726A (21.54%) and M694V (22.05%), which were also mainly heterozygous. M694I demonstrated the highest rate of homozygosity (29.41%), while K695R was detected exclusively in the homozygous form. The I692del mutation was not identified in any patient. CONCLUSION: This study provides baseline data on the frequency of commonly screened MEFV gene variants in Jordanian adolescents with FMF. E148Q, V726A, and M694V were the most frequent mutations, mainly in the heterozygous state, reflecting genetic heterogeneity in the study cohort. Further large-scale studies are warranted to elucidate genotype-phenotype correlations and refine diagnostic and management strategies for FMF in Jordan.