Soylu Alper, Kasap Belde, Türkmen Mehmet, Saylam Gül Sağn, Kavukçu Salih
Department of Pediatrics, Division of Nephrology, Dokuz Eylül University Medical Faculty, Izmir, Turkey.
J Clin Rheumatol. 2006 Apr;12(2):93-6. doi: 10.1097/01.rhu.0000208635.64537.10.
Familial Mediterranean fever is characterized by recurrent polyserositis episodes associated with fever. However, the clinical spectrum of this disease has been expanded recently and myalgia is now a frequently recognized component. Protracted febrile myalgia syndrome was first described in patients with familial Mediterranean fever in 1994. This syndrome is characterized by severe paralyzing myalgia, high fever, abdominal pain, diarrhea, arthritis/arthralgia, and transient vasculitic rashes mimicking Henoch-Schonlein purpura. Recently, we evaluated 6 patients with the clinical picture of protracted febrile myalgia syndrome in our clinic. One of them was a patient with known familial Mediterranean fever, but the others were subsequently diagnosed to have familial Mediterranean fever by mutational analyses. Thus, introduction of genetic analysis would possibly change the diagnostic criteria for familial Mediterranean fever. In addition, all 6 patients presented in the spring months when streptococcal infections are at their peak rate and 3 of them had elevated ASO levels indicating that streptococci could be one of the agents triggering protracted febrile myalgia syndrome.
家族性地中海热的特征是反复出现与发热相关的多浆膜炎发作。然而，这种疾病的临床谱最近有所扩展，肌痛现在是一个经常被认识到的组成部分。持续性发热性肌痛综合征于1994年首次在家族性地中海热患者中被描述。该综合征的特征是严重的麻痹性肌痛、高热、腹痛、腹泻、关节炎/关节痛，以及类似过敏性紫癜的短暂性血管炎性皮疹。最近，我们在我们的诊所评估了6例具有持续性发热性肌痛综合征临床表现的患者。其中1例是已知患有家族性地中海热的患者，但其他患者随后通过突变分析被诊断为患有家族性地中海热。因此，基因分析的引入可能会改变家族性地中海热的诊断标准。此外，所有6例患者均在链球菌感染率最高的春季就诊，其中3例抗链球菌溶血素O（ASO）水平升高，表明链球菌可能是触发持续性发热性肌痛综合征的病原体之一。
