Protracted Febrile Myalgia in a Child as the Presenting Sign of Familial Mediterranean Fever: Case Report and Review of the Literature

Year 2011, Volume: 2011 Issue: 2, 222 - 223, 01.02.2011

İbrahim Gökçe Erkan Demirkaya Faysal Gök

https://doi.org/10.5174/tutfd.2009.02972.3

Abstract

Protracted febrile myalgia (PFM) is a rare form of vasculitic disease which is an uncommon dramatic manifestation of familial Mediterranean fever (FMF), characterized by severe crippling myalgia and high fever. We describe a 14-year-old boy who presented with fever, abdominal pain and severe myalgia in all his muscles for 5 days. The diagnosis of PFM was considered based on the presence of fever, paralyzing myalgia with normal CPK, elevated CRP and ESR. Thus, we started prednisolone treatment and his symptoms disappeared and acute-phase reactants declined rapidly. Mutational analysis of the MEFV gene demonstrated homozygote M694V mutation. Thus, he was diagnosed as PFM and FMF. In this report, we present a child with PFM as the sole feature preceding the diagnosis of FMF, and draw attention to the PFM for the diagnosis of FMF even the patient does not fulfill the criteria for the clinical diagnosis.

Keywords

Familial Mediterranean fever, myalgia, protracted febrile myalgia, children

Protracted Febrile Myalgia in a Child as the Presenting Sign of Familial Mediterranean Fever: Case Report and Review of the Literature

Abstract

References

• Langevitz P, Zemer D, Livneh A, Shemer J, Pras M. Protracted myalgia syndrome in patients with familial Mediterrenean fever. J Rheumatol 1994;21:1708-9.
• Majeed HA, Al-Qudah AK, Qubain H, Shahin HM. The clinical patterns of myalgia in children with familial Mediterranean fever. Semin Arthritis Rheum 2000;30:138-43.
• Sohar E, Gafni J, Pras M, Heller H. Familial Mediterranean Fever. A survey of 470 cases and review of the literature. Am J Med 1967;43:227-53.
• Barakat MH, Kamik AM, Majeed HA, El-Sobki N, Fenech F. Fa- milial Mediterranean fever (recurrent hereditary polyserositis) in Arabs: a study of 175 patients and review of the literature. Q J Med 1986;60:837-46.
• Soylu A, Ozturk Y, Kasap B, Akman N, Türkmen M, Kavukcu S. Clinical quiz: A pediatric case presenting with fever and diffuse myalgia. Rheumatol Int 2005;25:314-6.
• Ertekin V, Selimoglu MA, Alp H, Yılmaz N. Familial Mediterranean fever protracted febrile myalgia in children: report of two cases. Rheumatol Int 2005;25:398-400.
• Majeed HA, Rawashdeh M, El-Shanti H, Qubain H, Khuribulos N, Shahin HM. Familial Mediterrenean fever in children: the expand- ed clinical proŞ le. Q J Med 1999;92:309-18.
• Majeed HA, El-Khateeb M, El-Shanti H, Rabaiha ZA, Tayeh M, Najib D. The spectrum of familial Mediterrenean fever gene mu- tations in Arabs: report of a large series. Semin Arthritis Rheum 2005;34:813-8.
• Odabas AR, Cetinkaya R, Selcuk Y, Bilen H. Familial Mediterre- nean fever. South Med J 2002;95:1400-3.
• Kaplan E, Mukamel M, Barash J, Brik R, Padeh S, Berkun Y, et al. Protracted febrile myalgia in children and young adults with fa- milial Mediterranean fever: analysis of 15 patients and suggested criteria for working diagnosis. Clin Exp Rheumatol 2007;25:114-7.
• Soylu A, Kasap B, Türkmen M, Salyam GS, Kavukcu S. Febrile Myalgia Syndrome in Familial Mediterranean Fever. J Clin Rheu- matol 2006;12:93-6.