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家族性地中海热与白塞病并存 1 例报告并文献复习

Concurrence of familial Mediterranean fever and Behçet's disease: a case report and review of the literature.

机构信息

Department of Medicine, University of Ottawa, 501 Smyth Rd, Ottawa, ON, Canada.

出版信息

J Med Case Rep. 2023 Oct 22;17(1):438. doi: 10.1186/s13256-023-04185-5.

Abstract

BACKGROUND

Familial Mediterranean fever and Behçet's disease are distinct disorders that are prevalent in the Mediterranean and Middle Eastern populations. They are characterized by unprovoked inflammatory episodes caused by overexpression of proinflammatory cytokines. Although reported previously, the overlapping presentation of familial Mediterranean fever and Behçet's disease remains uncommon.

CASE PRESENTATION

A 46-year-old Lebanese-Canadian man who presented with recurrent oral and genital ulcers, polyarticular synovitis, ocular swelling, recurrent infections, and fevers was later found to have heterozygous mutations of pathogenic MEFV c.2080A > G (p. Met 694Val) and c.2082G > A (p.Met694IIe) genes indicating familial Mediterranean fever. He was treated with prednisone, colchicine, and azathioprine, with inadequate symptoms control. Treatment was complicated by recurrent infections.

CONCLUSIONS

Our case contributes to the growing literature demonstrating the presentation of predominantly Behçet's disease-like features in the setting of diagnosis of familial Mediterranean fever. These findings emphasize that clinicians should be aware that patients with familial Mediterranean fever may present with Behçet's disease-like clinical manifestations.

摘要

背景

家族性地中海热和贝切特病是两种不同的疾病,在地中海和中东人群中较为常见。它们的特征是由促炎细胞因子过度表达引起的无明显诱因的炎症发作。尽管以前有报道,但家族性地中海热和贝切特病的重叠表现仍然不常见。

病例介绍

一位 46 岁的黎巴嫩裔加拿大男性,表现为复发性口腔和生殖器溃疡、多关节炎性滑膜炎、眼部肿胀、反复感染和发热,后来发现存在致病性 MEFV c.2080A>G(p.Met694Val)和 c.2082G>A(p.Met694IIe)杂合突变,提示家族性地中海热。他接受了泼尼松、秋水仙碱和硫唑嘌呤治疗,但症状控制不佳。治疗因反复感染而变得复杂。

结论

我们的病例增加了越来越多的文献证据,表明在家族性地中海热诊断的背景下,主要表现为贝切特病样特征。这些发现强调了临床医生应该意识到家族性地中海热患者可能表现出贝切特病样的临床表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004c/10590508/e4e1362ef695/13256_2023_4185_Fig1_HTML.jpg

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