Lee W Y, Tsai S, Kao J H, Lai M Y
Department of Internal Medicine and Emergency Medicine, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1993 Nov;92(11):1013-6.
A 26-year-old man had suffered from recurrent abdominal pain, ascites and arthralgia since childhood. The symptoms occurred usually during the winter, and each attack lasted for two to three days. Initially, the frequency was about once a year, but it had increased to once every one to four months after an exploratory laparotomy carried out four years ago. Leukocytosis accompanied each episode. Many laboratory examinations and imaging studies failed to show pathologic lesions. Laparoscopic examination revealed only yellowish ascites with a hyperemic mesentery and omentum. There were never any sequelae after the attacks. After prophylaxis with colchicine 0.6 mg three times a day, no more attacks occurred. Familial Mediterranean fever (familial paroxysmal polyserositis) was the most likely diagnosis. Recognizing this disease entity in Taiwanese patients may help to avoid unnecessary operations.
一名26岁男性自童年起就反复出现腹痛、腹水和关节痛。这些症状通常在冬季发作，每次发作持续两到三天。起初，发作频率约为每年一次，但在四年前进行剖腹探查术后，发作频率增加到每1至4个月一次。每次发作都伴有白细胞增多。多项实验室检查和影像学研究均未发现病理病变。腹腔镜检查仅发现淡黄色腹水，伴有肠系膜和网膜充血。发作后从未留下任何后遗症。每天三次服用0.6毫克秋水仙碱进行预防后，未再发作。家族性地中海热（家族性阵发性多浆膜炎）是最可能的诊断。在台湾患者中认识到这种疾病实体可能有助于避免不必要的手术。
