Familial Mediterranean fever occurring in an elderly Japanese woman with recent-onset rheumatoid arthritis.
A 60-year-old woman with a two-year history of rheumatoid arthritis (RA) developed recurrent two- to three-day attacks of fever (>38 °C) accompanied by monoarthritis of the right hip joint. The first attack occurred two months after beginning anti-tumor necrosis factor-α therapy. Since a diagnosis of infectious arthritis was suspected, the therapy was discontinued. Thereafter, the patient repeated similar episodes; however, oral colchicine effectively controlled the attacks. The patient was diagnosed to have familial Mediterranean fever (FMF). The clinical manifestations of FMF mimic infectious complications during anti-RA therapy. Clinicians should therefore consider the possibility of FMF development in RA patients exhibiting recurrent febrile attacks.
Department of Rheumatology, Clinical Research Center for Rheumatic Disease, NHO Kumamoto Saishunsou National Hospital, Japan. moris@saisyunsou1.hosp.go.jp
Shunsuke
S
Mori
Kensuke
K
Yonemura
Kiyoshi
K
Migita
D000911:Antibodies, Monoclonal / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000009:adverse effects; D001170:Arthritis, Infectious / Q000175:diagnosis; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000628:therapy; D003078:Colchicine / Q000627:therapeutic use; D003598:Cytoskeletal Proteins / Q000235:genetics; D003951:Diagnostic Errors; D010505:Familial Mediterranean Fever / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D009154:Mutation; D000071198:Pyrin; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D003598:Cytoskeletal Proteins; D007166:Immunosuppressive Agents; C000604192:MEFV protein, human; D000071198:Pyrin; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D003078:Colchicine; D008727:Methotrexate