Atypical Familial Mediterranean Fever Complicated with Gastrointestinal Amyloidosis Diagnosed due to Paroxysmal Arthralgia and Intractable Diarrhea, Successfully Treated with Tocilizumab.
Abdominal Pain
/ etiology
Amyloidosis
/ complications
Antibodies, Monoclonal, Humanized
/ therapeutic use
Arthralgia
/ complications
Colchicine
/ therapeutic use
Diarrhea
/ complications
Familial Mediterranean Fever
/ complications
Fever
/ complications
Gastrointestinal Diseases
/ complications
Gout Suppressants
/ therapeutic use
Humans
Male
Middle Aged
Familial Mediterranean fever
amyloidosis
tocilizumab
Journal
Internal medicine (Tokyo, Japan)
ISSN: 1349-7235
Titre abrégé: Intern Med
Pays: Japan
ID NLM: 9204241
Informations de publication
Date de publication:
15 Jun 2019
15 Jun 2019
Historique:
pubmed:
5
2
2019
medline:
26
9
2019
entrez:
5
2
2019
Statut:
ppublish
Résumé
A 53-year-old man with recurrent episodes of large joint pain and a low-grade fever at irregular intervals for 16 years developed right knee and ankle arthralgia, watery diarrhea, and abdominal pain. Following an ileum and colon biopsy, he was diagnosed with gastrointestinal amyloidosis. We suspected familial Mediterranean fever (FMF) based on his history and administered colchicine; his symptoms subsequently improved. Thus, he was diagnosed with atypical FMF. After tocilizumab administration, the amyloid deposits disappeared. This case suggests that physicians should consider FMF even in cases with atypical symptoms in order to prevent the progression of amyloidosis and that amyloid deposits can be eliminated by interleukin (IL)-6 inhibition.
Identifiants
pubmed: 30713308
doi: 10.2169/internalmedicine.2277-18
pmc: PMC6630114
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Gout Suppressants
0
tocilizumab
I031V2H011
Colchicine
SML2Y3J35T
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1781-1785Références
N Engl J Med. 2003 Aug 7;349(6):583-96
pubmed: 12904524
Medicine (Baltimore). 2005 Jan;84(1):1-11
pubmed: 15643295
Arthritis Rheum. 2007 May;56(5):1706-12
pubmed: 17469185
N Engl J Med. 2007 Jun 7;356(23):2361-71
pubmed: 17554117
Ann Rheum Dis. 2009 Jul;68(7):1234-5
pubmed: 19525412
Clin Rheumatol. 2010 Oct;29(10):1195-7
pubmed: 20229259
Nihon Rinsho Meneki Gakkai Kaishi. 2011;34(5):355-60
pubmed: 22041422
Medicine (Baltimore). 2012 Nov;91(6):337-43
pubmed: 23111802
Lancet. 2012 Dec 8;380(9858):2052
pubmed: 23217869
Medicine (Baltimore). 2014 May;93(3):158-64
pubmed: 24797171
Rheumatology (Oxford). 2015 Mar;54(3):564-5
pubmed: 25504961
Clin Exp Rheumatol. 2015 Nov-Dec;33(6 Suppl 94):S169
pubmed: 25572486
Mod Rheumatol. 2016 Jul;26(4):610-3
pubmed: 25619282
Ann Rheum Dis. 2016 Apr;75(4):644-51
pubmed: 26802180
Mod Rheumatol. 2016 Sep;26(5):637-41
pubmed: 26939747
Arthritis Res Ther. 2016 Jul 30;18:175
pubmed: 27473114
Arthritis Rheum. 1994 Dec;37(12):1804-11
pubmed: 7986228
Arthritis Rheum. 1997 Oct;40(10):1879-85
pubmed: 9336425