Clinical Communication to the Editor|Articles in Press

Effect of Colchicine on Recurrent Serositis in Familial Mediterranean Fever

Published:February 22, 2023DOI:
      A 78-year-old man was admitted with a 2-year history of periodic fever of unknown etiology with frequent remissions and exacerbations of pericardial and pleural effusions. He had a history of tuberculosis at 22 years of age, and had no relevant family history. Chest radiography (CX-R) demonstrated cardiomegaly and left-sided pleural effusion (Figure 1A). Chest computed tomography revealed extensive pericardial effusion and left encapsulated pleural effusion (Figure 1B). Oxygen saturation was 92% on 2 L/min of oxygen. Based on the available clinical and radiological findings, the differential diagnosis encompassed malignant lymphoma, tuberculosis pleuropericarditis, collagen diseases, and autoinflammatory disorders such as familial Mediterranean fever.
      Figure 1
      Figure 1(A) Chest radiography on admission showed cardiomegaly and left-sided pleural effusion. (B) Chest CT on admission showed pericardial effusion and predominantly left-sided encapsulated pleural effusion. (C) Chest radiography after a week of admission. Progression of cardiomegaly and bilateral pleural effusion were observed. (D) The results of Mediterranean fever gene analysis in the present case and a healthy control (wild type). In the present case, a C to G transition in codon 165 and a C to T transition in codon 314 were detected. (E) Chest radiography after the initiation of treatment with colchicine. Cardiomegaly and bilateral pleural effusion were dramatically improved. (F) Chest CT after the initiation of treatment with colchicine showed dramatic improvement of pericardial and bilateral pleural effusions.
      CT, computed tomography.

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