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Prolonged Peritoneal Attack: A Rare but Crucial Clinical Presentation of Familial Mediterranean Fever

Hirohisa Fujikawa1, Takayuki Ando1, Junichi Hirahashi1

  • 1Center for General Medicine Education, School of Medicine, Keio University, Tokyo, JPN.

Cureus
|October 11, 2024
PubMed

Insights

Familial Mediterranean Fever (FMF) can present with prolonged abdominal pain, lasting over a week. Early diagnosis and colchicine treatment are crucial for managing this rare clinical characteristic.

Area of Science:

  • Genetics
  • Internal Medicine
  • Rheumatology

Background:

  • Familial Mediterranean Fever (FMF) is an autoinflammatory disorder characterized by recurrent inflammatory episodes.
  • Abdominal pain and fever are common symptoms, typically resolving within 24-48 hours.

Observation:

  • A 50-year-old Japanese male presented with recurrent episodes of abdominal pain and fever since his late 20s.
  • His abdominal pain episodes lasted 1-2 weeks, significantly longer than the typical FMF presentation.
  • Immobility was necessary during episodes due to pain exacerbation with movement.

Findings:

  • Genetic analysis revealed MEFV gene exon 10 mutations (p.Met694Ile), confirming the FMF diagnosis.
  • Colchicine therapy proved effective in controlling the patient's FMF attacks.
  • The case highlights prolonged abdominal pain as an uncommon but possible clinical manifestation of FMF.

Implications:

  • Awareness of rare clinical presentations, such as prolonged abdominal pain, is essential for accurate FMF diagnosis.
  • Timely diagnosis and treatment, including colchicine, can improve patient quality of life.
  • Effective management of FMF is critical to prevent long-term complications like secondary amyloidosis.
Keywords:
familial mediterranean feverperiodic fever syndromeprolonged abdominal painrare cause of acute abdominal painrecurrent feverserositis

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