Table 2.

Check list before considering colchicine resistance.

□	Verify that the diagnosis of FMF is accurate
□	Verify that reported symptoms are related to inflammation (Check inflammatory markers during symptoms)
□	Eliminate common causes of fever and pain (infection, leukemia, …)
□	Question the patient about personal, social or psychological problems that may be triggers for inflammatory attacks      - Propose behavioral approaches for stress management
□	Ensure compliance at full dose for 3–6 months If the maximum dose is not reached, increase gradually the colchicine dosage by 0.5 mg (0.25 mg before the age of 5) every 3 months
□	Ensure colchicine tolerance by      - Dietary modifications (limit lactose intake)      - Splitting the total daily dose      - Associating antidiarrheal and spasmolytic agents to colchicine
□	In patients with a sudden deterioration of FMF despite full compliance of colchicine, look for other causes of inflammation:      - Inflammatory rheumatism, vasculitis      - Mild myeloid hemopathy (in the elderly)      - Chronic peritonitis or peritoneal mesothelioma (in the elderly)
□	Document prospectively the attack recurrence for 3–6 months in order to confirm the number of reported inflammatory episodes