FMF is an autosomal-recessive autoinflammatory disease characterized by episodic, self-limiting attacks characterized by fever, abdominal pain, pleurisy, arthritis and erysipelas-like-erythema. Most patients remain free from fever and inflammation in between the episodes. Systemic amyloidosis is the most severe manifestation of the disease. It results from amyloid protein-A deposition, commonly affecting the kidneys and sometimes adrenal glands, intestine, spleen, lungs and testis. Ethnicity appears to contribute to the risk of developing amyloidosis, with reported higher frequency in Sephardic Jews of North African ancestry, particularly in comparison to Ashkenazi Jews. The ability to use genetic testing recently allowed us to make a determination whether prophylactic versus intermittent colchicine was most appropriate for a patient with a Sephardic father and Ashkenazi mother.