Familial Mediterranean fever presenting with pulmonary embolism

Conn Med. 2011 Jan;75(1):17-9.

Abstract

Familial Mediterranean fever (FMF) is the autoinflammatory disease and hereditary periodic fever syndrome that most commonly affects people of Eastern Mediterranean origin. It is characterized by recurrent self-limited attacks of fever and serositis, with an increase in acute-phase reactant markers, and is transmitted in an autosomal recessive pattern. Inflammation shifts the hemostatic mechanisms favoring thrombosis. There are few reports of an increased risk of hypercoagulability in patients with FMF in the absence of amyloidosis and nephrotic syndrome. In this case report, we describe a 43-year-old Turkish patient who presented with right-sided pleuritic chest pain and pulmonary embolism. The patient described having prior similar attacks of serositis, but had never been diagnosed with FMF. Further workup revealed an increase in acute phase reactants, negative hypercoagulability studies and heterozygosity for the M694V mutation in the pyrin (MEFV) gene. We identified untreated FMF and chronic inflammation as his only risk factor for pulmonary embolism. With this case report, we support recent studies that have demonstrated that inflammation may lead to prothrombotic states in patients with FMF.

Publication types

  • Case Reports

MeSH terms

  • Acetaminophen / therapeutic use
  • Adult
  • Analgesics, Non-Narcotic / therapeutic use
  • Anticoagulants / therapeutic use
  • Chest Pain / drug therapy
  • Chest Pain / etiology
  • Colchicine / therapeutic use
  • Diagnosis, Differential
  • Familial Mediterranean Fever / complications*
  • Familial Mediterranean Fever / diagnosis
  • Familial Mediterranean Fever / drug therapy
  • Follow-Up Studies
  • Heparin / therapeutic use
  • Humans
  • Male
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology*
  • Serositis / diagnosis
  • Serositis / drug therapy
  • Serositis / etiology
  • Tubulin Modulators / therapeutic use
  • Turkey
  • Warfarin / therapeutic use

Substances

  • Analgesics, Non-Narcotic
  • Anticoagulants
  • Tubulin Modulators
  • Acetaminophen
  • Warfarin
  • Heparin
  • Colchicine