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[Recurrent pericarditis in familial Mediterranean fever]
Abstract:
The diagnosis of familial Mediterranean fever (FMF) is based on clinical evidence, since there is no specific diagnostic test. Manifestations are recurrent attacks of fever accompanied by serositis, mainly involving the peritoneum, pleura and joints. Although pericardial inflammation has been considered rare, when echocardiography is used to detect it, an incidence of 27% has been reported. We describe a boy of 11 and a girl of 15 years who developed recurrent pericarditis despite treatment with steroids, nonsteroidal anti-inflammatory drugs and pericardiocentesis. A few months after the first episode, both patients were admitted with typical bouts of FMF. Continuous prophylaxis with colchicine was initiated, and there were no further attacks during 18 and 10 month follow-ups, respectively. We conclude that acute or recurrent pericarditis in children or young adults of Mediterranean origin may be due to FMF.
Insights
Familial Mediterranean Fever (FMF) can cause recurrent pericarditis in young people of Mediterranean descent. Early colchicine prophylaxis effectively prevents FMF-related pericarditis attacks.
Area of Science:
- Rheumatology
- Pediatrics
- Cardiology
Background:
- Familial Mediterranean Fever (FMF) diagnosis relies on clinical symptoms, lacking a specific test.
- FMF typically presents with fever and serositis (peritoneum, pleura, joints).
- Pericardial inflammation in FMF is often underestimated, with echocardiography revealing a 27% incidence.
Observation:
- Two young patients, an 11-year-old boy and a 15-year-old girl, experienced recurrent pericarditis.
- Standard treatments including steroids, NSAIDs, and pericardiocentesis were ineffective.
- Both patients later presented with classic FMF symptoms.
Findings:
- Recurrent pericarditis in these patients resolved after initiating continuous colchicine prophylaxis.
- No further pericarditis or FMF attacks occurred during 18 and 10-month follow-ups.
- This suggests a strong link between FMF and recurrent pericarditis in these cases.
Implications:
- Acute or recurrent pericarditis in children and young adults of Mediterranean origin should prompt consideration of FMF.
- Prompt diagnosis and colchicine treatment can prevent FMF-related pericarditis.
- Highlights the importance of considering FMF in unexplained serositis, including pericarditis.