title: Usefulness of Small Intestinal Endoscopy in a Case of Adult-onset Familial Mediterranean Fever Associated with Jejunoileitis.
abstract: A 66-year-old Japanese man consulted our institution due to paroxysmal and repetitive bouts of fever and abdominal pain that had persisted for more than one week. Capsule and double-balloon endoscopy (DBE) showed petal-shaped mucosal redness with white hemming in the jejunum and ileum, and histopathology of the biopsy specimens revealed villous atrophy and cryptitis with extensive severe neutrophil infiltration. A genetic examination disclosed compound heterozygous MEFV mutations (E84K, P369S), and familial Mediterranean fever was diagnosed. Treatment with colchicine and infliximab was very effective in inducing the complete disappearance of symptoms and normalization of the endoscopic findings. To the best of our knowledge, this is the first report to describe the findings of small intestinal endoscopic images obtained using capsule and DBE.
authors.affiliation: Department of Endoscopy, Mie University Hospital, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitade
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Horiki
authors.forename: Masaki
authors.initials: M
authors.lastname: Katsurahara
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Totoki
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Harada
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tano
authors.forename: Reiko
authors.initials: R
authors.lastname: Yamada
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hamada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inoue
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Tanaka
authors.forename: Esteban C
authors.initials: EC
authors.lastname: Gabazza
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Masanori
authors.initials: M
authors.lastname: Tanaka
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D003078:Colchicine / Q000627:therapeutic use; D016099:Endoscopy, Gastrointestinal; D010505:Familial Mediterranean Fever / Q000150:complications* / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006579:Heterozygote; D006801:Humans; D007079:Ileitis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D000069285:Infliximab / Q000627:therapeutic use; D007579:Jejunal Diseases / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011237:Predictive Value of Tests
chemical_list: D005765:Gastrointestinal Agents; D000069285:Infliximab; D003078:Colchicine