Subclinical inflammation in a case of menstruation-induced familial Mediterranean fever: A case report
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Authors
Hara, Kazusato
Endo, Yushiro
Ishida, Midori
Fujita, Yuya
Tsuji, Sosuke
Takatani, Ayuko
Shimizu, Toshimasa
Sumiyoshi, Remi
Igawa, Takashi
Umeda, Masataka
Issue Date
2018-09
Type
Article
Language
en_US
Keywords
Subclinical Inflammation , Menstruation , Mediterranean Fever , Familial Mediterranean Fever
Alternative Title
Abstract
Rationale: Because most patients with familial Mediterranean fever (FMF) have attacks without any prodromal symptoms, and since it is suggested that patients with FMF have subclinical inflammation even during remission, a daily continuous administration of colchicine is recommended for patients with FMF even during remission. However, it is possible that intermittent colchicine therapy only during FMF attacks prevents the attacks completely in patients with FMF with expectable attacks.
Patient concerns: A 31-year-old Japanese woman suffered high fever and arthralgia lasting for 2 to 3 days after each menstrual period's start. She was admitted to our hospital, and colchicine was administered immediately after her next period's start, and the febrile attack was completely prevented.
Diagnoses: We eventually diagnosed typical FMF.
Interventions: Her remission has been maintained by intermittent colchicine therapy.
Outcomes: The genetic analysis revealed the G304R heterozygous mutation in exon 2 of the MEFV gene. Cytokine analysis suggested subclinical inflammation during the remission period.
Lessons: This case suggests that taking an extensive medical history (including the relationship between fever attack and menstruation) is important in the diagnosis of female patients with FMF. This case also suggests that a continuous administration of colchicine may have to be considered to regulate subclinical inflammation even in patients with FMF with completely expectable attacks.
Description
Citation
Hara, K., Endo, Y., Ishida, M., Fujita, Y., Tsuji, S., Takatani, A., Shimizu, T., Sumiyoshi, R., Igawa, T., Umeda, M., Fukui, S., Nishino, A., Kawashiri, S. Y., Iwamoto, N., Ichinose, K., Tamai, M., Nakamura, H., Origuchi, T., Migita, K., Kawakami, A., … Koga, T. (2018). Subclinical inflammation in a case of menstruation-induced familial Mediterranean fever: A case report. Medicine, 97(38), e12305. https://doi.org/10.1097/MD.0000000000012305
Publisher
Medicine