Back to Journals » International Medical Case Reports Journal » Volume 11

A rare cause of fever in an adult: a case of familial Mediterranean fever

Authors Erdem I, Saritas F, Karaali R, Ardic E, Emeksiz GK, Kara SP, Yaniker RM, Bol O

Received 3 August 2017

Accepted for publication 17 January 2018

Published 13 March 2018 Volume 2018:11 Pages 37—40


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Ronald Prineas

Ilknur Erdem,1 Fatih Saritas,2 Ritvan Karaali,1 Enes Ardic,1 Gaye Kubra Emeksiz,3 Sonat Pinar Kara,3 R Merve Yaniker,4 Oguzhan Bol4

1Department of Infectious Diseases, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey; 2Clinic of Rheumatology, Tekirdag State Hospital, Tekirdag, Turkey; 3Department of Internal Medicine, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey; 4Department of Emergency Medicine, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey

Background: Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent fever attacks and serositis. Nonspecific manifestations of the FMF can mimic many common acquired disorders such as infections and acute abdomen. This can delay recognition for many years and lead to comprehensive assessments and even unnecessary surgeries. Untreated FMF may lead to serious complications such as end-stage renal disease and malabsorption due to amyloid deposits in the kidneys and the digestive system. Colchicine has been used successfully to treat FMF since the 1970s.
Case presentation: A 30-year-old male was admitted to our hospital with the complaints of fever, nausea, vomiting, and generalized myalgia and weakness for 15 days. The day after hospitalization, the patient had abdominal pain. Approximately a month before, the patient was treated for a diagnosis of urinary tract infection, with similar complaints. MEFV gene mutation analysis revealed homozygosity for the R202Q mutation. FMF was considered in the patient due to the presence of recurrent febrile serositis attacks and R202Q homozygous mutation in the FMF gene analyses. Colchicine was started 3×0.5 mg/day by consulting rheumatology on day 8 of admission. After the colchicine treatment, the patient’s complaints markedly improved and the inflammatory markers returned to normal levels. At his follow-up visit at 6 months, the patient remained asymptomatic.
Conclusion: We present a case of adult-onset FMF accompanied by peritonitis as a disease among the rare causes of fever in an adult who was treated with colchicine. Based on this case, we suggest that FMF should be kept in mind in the differential diagnosis of patients with periodic fever syndromes.

Keywords: familial Mediterranean fever, fever, peritonitis

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]