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Hypoadrenal syndrome in a patient with amyloidosis secondary to familial Mediterranean fever

Mehrnaz Asadi Gharabaghi1, Aram Behdadnia, Mehrnoush Asadi Gharabaghi

  • 1Department of Pulmonary Medicine, Tehran University of Medical Sciences, Iran. asadi_m@tums.ac.ir

BMJ Case Reports
|February 1, 2013
PubMed

Insights

Familial Mediterranean fever (FMF) amyloidosis can affect adrenal glands, causing rare adrenal insufficiency. This case highlights challenges in diagnosing adrenal function in FMF patients with renal amyloidosis.

Area of Science:

  • Endocrinology
  • Nephrology
  • Rheumatology

Background:

  • Familial Mediterranean fever (FMF) is an autoinflammatory disease.
  • Amyloidosis is a known complication of FMF, often affecting the kidneys.
  • Adrenal gland involvement in FMF-associated amyloidosis is uncommon.

Observation:

  • A 42-year-old male with FMF and renal failure due to amyloidosis presented with complications.
  • The patient exhibited signs suggestive of adrenal insufficiency.
  • Interpreting adrenal function tests was challenging due to FMF's neuroendocrine-immune aspects and proteinuria from renal amyloidosis.

Findings:

  • The case report details a rare instance of adrenal insufficiency in a patient with FMF and renal amyloidosis.
  • This presentation underscores the potential for widespread organ involvement in FMF complications.
  • Diagnostic challenges in assessing adrenal function in this context were noted.

Implications:

  • Highlights the importance of considering adrenal insufficiency in FMF patients with amyloidosis, especially with renal involvement.
  • Suggests a need for refined diagnostic approaches for adrenal function in FMF patients with complex comorbidities.
  • Emphasizes the systemic impact of FMF and its complications on multiple organ systems.

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