Sustained, progressive, nonresolving abdominal pain: a previously undescribed clinical presentation of familial Mediterranean fever.
Familial Mediterranean fever (FMF) is a genetic disorder characterized by sporadic, acute attacks of fever and serosal inflammation. Typical manifestations are recurrent febrile episodes of acute instauration for brief duration (1 to 4 days) that is associated with severe pain due to serositis at one or more sites. Abdominal crisis occurs in 95% of the patients. Treatment with colchicine is highly effective as preventive treatment, but it is considered to be ineffective for the treatment of established acute attacks. As mentioned, untreated crisis resolves spontaneously in 1 to 4 days. Prolonged, nonresolving crisis of abdominal pain refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, with fever and elevation of acute phase reactants that resolves after the administration of colchicine, is a clinical presentation undescribed hitherto. The aim of this paper is to report a patient with this distinctively unusual clinical presentation of FMF.
Radisic
Marcelo
M
Internal Medicine, Sanatorio de la Trinidad (Palermo), Capital Federal, Argentina. mradisic@intramed.net.ar
Santamarina
Joaquin
J
Froment
Roberto
R
D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D000209:Acute-Phase Proteins / Q000378:metabolism; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use*; D018450:Disease Progression; D010505:Familial Mediterranean Fever / Q000150:complications*; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D019233:Retreatment; D017211:Treatment Failure; D016896:Treatment Outcome
D000209:Acute-Phase Proteins; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003078:Colchicine