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Protracted febrile myalgia mimicking polyarteritis nodosa
1Department of Pediatric Nephrology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey. zbircan@superonline.com
Summary
Familial Mediterranean Fever with protracted febrile myalgia can mimic polyarteritis nodosa, presenting with severe pain and fever. Prompt diagnosis and steroid treatment are key for managing these cases effectively.
Area of Science:
- Rheumatology
- Internal Medicine
Background:
- Polyarteritis nodosa (PAN) presents with systemic symptoms like fever, weight loss, and pain.
- Familial Mediterranean Fever (FMF) is an autoinflammatory disease that can manifest with protracted febrile myalgia (PFM).
Observation:
- This report details 6 cases where PFM mimicked PAN, characterized by prolonged severe muscle and abdominal pain.
- Patients exhibited recurrent febrile episodes, hypertension, and elevated acute-phase reactants, with normal creatine kinase and complement levels.
Findings:
- Four patients were initially misdiagnosed with PAN, necessitating further investigation like angiography, which proved normal in one case.
- All 6 patients experienced symptom resolution, including hypertension, with corticosteroid therapy.
Implications:
- PFM should be considered in the differential diagnosis of vasculitis, particularly when myalgia is prominent.
- Recognizing PFM in FMF patients allows for quicker treatment with corticosteroids, avoiding extensive workups and reducing patient suffering.
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