Sugie Masayuki, Ouchi Takahiro, Kishida Dai, Yasaki Shunji
Department of Neurology Shin-yurigaoka General Hospital Kanagawa Japan.
Department of Medicine (Neurology and Rheumatology) Shinshu University School of Medicine Nagano Japan.
Neurol Clin Neurosci. 2018 Nov;6(6):191-193. doi: 10.1111/ncn3.12232. Epub 2018 Sep 24.
We report an atypical case of familial Mediterranean fever (FMF) concomitant with chronic aseptic meningitis. The patient experienced fever, abdominal and back pain because of serositis, and headache because of aseptic meningitis for 4 weeks. Blood examinations revealed increased white blood cells and serum amyloid A level. Medications, including steroids, did not improve his symptoms. However, the patient experienced immediate relief after the administration of colchicine. We diagnosed him as having atypical FMF based on the symptoms, especially positive response to colchicine, and heterozygous mutations on exon2 and 5 (E148Q/S503C) in gene. Unlike typical FMF, a cause of recurrent aseptic meningitis, atypical FMF might be an underdiagnosed cause of chronic aseptic meningitis.
我们报告了一例伴有慢性无菌性脑膜炎的非典型家族性地中海热(FMF)病例。患者因浆膜炎出现发热、腹部和背部疼痛,因无菌性脑膜炎出现头痛,持续4周。血液检查显示白细胞和血清淀粉样蛋白A水平升高。包括类固醇在内的药物治疗均未能改善其症状。然而,患者在服用秋水仙碱后症状立即缓解。根据症状,尤其是对秋水仙碱的阳性反应以及该基因外显子2和5(E148Q/S503C)上的杂合突变,我们诊断他患有非典型FMF。与典型FMF(复发性无菌性脑膜炎的一个病因)不同,非典型FMF可能是慢性无菌性脑膜炎一个未被充分诊断的病因。