Abstract
A 60-year-old woman with a two-year history of rheumatoid arthritis (RA) developed recurrent two- to three-day attacks of fever (>38 °C) accompanied by monoarthritis of the right hip joint. The first attack occurred two months after beginning anti-tumor necrosis factor-α therapy. Since a diagnosis of infectious arthritis was suspected, the therapy was discontinued. Thereafter, the patient repeated similar episodes; however, oral colchicine effectively controlled the attacks. The patient was diagnosed to have familial Mediterranean fever (FMF). The clinical manifestations of FMF mimic infectious complications during anti-RA therapy. Clinicians should therefore consider the possibility of FMF development in RA patients exhibiting recurrent febrile attacks.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Antibodies, Monoclonal / adverse effects
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Antirheumatic Agents / adverse effects
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Arthritis, Infectious / diagnosis
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Arthritis, Rheumatoid / complications*
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Arthritis, Rheumatoid / therapy
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Colchicine / therapeutic use
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Cytoskeletal Proteins / genetics
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Diagnostic Errors
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Familial Mediterranean Fever / complications*
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Familial Mediterranean Fever / diagnosis
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Familial Mediterranean Fever / drug therapy
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Female
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Humans
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Immunosuppressive Agents / adverse effects
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Infliximab
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Magnetic Resonance Imaging
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Methotrexate / adverse effects
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Middle Aged
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Mutation
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Pyrin
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
Substances
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Antibodies, Monoclonal
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Antirheumatic Agents
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Cytoskeletal Proteins
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Immunosuppressive Agents
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MEFV protein, human
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Pyrin
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Tumor Necrosis Factor-alpha
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Infliximab
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Colchicine
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Methotrexate