Colchicine-responsive chronic recurrent multifocal osteomyelitis associated with familial Mediterranean fever in the presence of MEFV mutation: A case report

Mod Rheumatol Case Rep. 2023 Dec 29;8(1):195-198. doi: 10.1093/mrcr/rxad027.

Abstract

A 38-year-old female was referred with a history of fever, polyarthralgia, and bone pain. She was diagnosed with chronic recurrent multifocal osteomyelitis based on imaging and biopsy findings. Non-steroidal anti-inflammatory drugs and bisphosphonate caused no improvement. Then, she developed recurrent diarrhoea and abdominal pain. Genetic testing revealed MEFV mutation. Based on the symptoms and genetic mutation results that emerged during the course of these events, she was diagnosed with familial Mediterranean fever. All symptoms, including bone pain, improved with daily colchicine administration. This case was considered familial Mediterranean fever complicated with a clinical diagnosis of chronic recurrent multifocal osteomyelitis, which is included in the spectrum of pyrine autoinflammatory diseases. Considering this case, patients with chronic recurrent multifocal osteomyelitis with MEFV gene variants may respond to colchicine.

Keywords: MEFV gene mutation; Chronic recurrent multifocal osteomyelitis; colchicine; pyrin-associated autoinflammatory diseases.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Adult
  • Colchicine / therapeutic use
  • Familial Mediterranean Fever* / complications
  • Familial Mediterranean Fever* / diagnosis
  • Familial Mediterranean Fever* / drug therapy
  • Female
  • Humans
  • Mutation
  • Osteomyelitis
  • Pyrin / genetics

Substances

  • Colchicine
  • Pyrin
  • MEFV protein, human

Supplementary concepts

  • Chronic recurrent multifocal osteomyelitis