Acute appendicitis in a 14-year-old boy with familial Mediterranean fever
Familial Mediterranean fever (FMF) is one manifestation of a heritable periodic fever syndrome that is characterized by recurrent attacks of febrile polyserositis, most frequently peritonitis. An FMF abdominal attack is often misdiagnosed as acute appendicitis, a more common cause of an acute abdom...
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doaj-e1ec4f1d705346db8a7c6a4106d60f262020-11-25T00:52:22ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662015-01-01314610.1016/j.epsc.2014.11.008Acute appendicitis in a 14-year-old boy with familial Mediterranean feverYoshihiko Sakurai0Takaaki Murata1Hirohisa Hirata2Takeshi Morita3Department of Pediatrics, Matsubara Tokushukai Hospital, 7-13-26 Amami-higashi, Matsubara, Osaka 580-0032, JapanDepartment of Surgery, Matsubara Tokushukai Hospital, 7-13-26 Amami-higashi, Matsubara, Osaka 580-0032, JapanDepartment of Surgery, Matsubara Tokushukai Hospital, 7-13-26 Amami-higashi, Matsubara, Osaka 580-0032, JapanDepartment of Surgery, Matsubara Tokushukai Hospital, 7-13-26 Amami-higashi, Matsubara, Osaka 580-0032, Japan Familial Mediterranean fever (FMF) is one manifestation of a heritable periodic fever syndrome that is characterized by recurrent attacks of febrile polyserositis, most frequently peritonitis. An FMF abdominal attack is often misdiagnosed as acute appendicitis, a more common cause of an acute abdomen. We report a 14-year-old boy with FMF who developed acute appendicitis during his follow-up. The patient had a several-year history of abdominal pain episodes, and was initially admitted for an acute abdominal attack. The attack resolved over three days, following administration of intravenous fluids, alone. Upon admission, serology revealed elevated serum levels of amyloid A. An analysis of the MEFV gene revealed compound heterozygous Glu148Gln/Ser503Cys, resulting in an FMF diagnosis. Seven months after discharge, the patient was re-admitted with an acute abdomen. Following ultrasonographically diagnosed appendicitis, an appendectomy was performed, and acute phlegmonous appendicitis was confirmed, based on the pathologic examination of the resected specimen. The present case suggests that upon examining an FMF patient with abdominal pain, appendicitis should not be arbitrarily discounted from the differential diagnosis. http://www.sciencedirect.com/science/article/pii/S2213576614001596Familial Mediterranean feverAcute abdomenAppendicitis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yoshihiko Sakurai Takaaki Murata Hirohisa Hirata Takeshi Morita |
spellingShingle |
Yoshihiko Sakurai Takaaki Murata Hirohisa Hirata Takeshi Morita Acute appendicitis in a 14-year-old boy with familial Mediterranean fever Journal of Pediatric Surgery Case Reports Familial Mediterranean fever Acute abdomen Appendicitis |
author_facet |
Yoshihiko Sakurai Takaaki Murata Hirohisa Hirata Takeshi Morita |
author_sort |
Yoshihiko Sakurai |
title |
Acute appendicitis in a 14-year-old boy with familial Mediterranean fever |
title_short |
Acute appendicitis in a 14-year-old boy with familial Mediterranean fever |
title_full |
Acute appendicitis in a 14-year-old boy with familial Mediterranean fever |
title_fullStr |
Acute appendicitis in a 14-year-old boy with familial Mediterranean fever |
title_full_unstemmed |
Acute appendicitis in a 14-year-old boy with familial Mediterranean fever |
title_sort |
acute appendicitis in a 14-year-old boy with familial mediterranean fever |
publisher |
Elsevier |
series |
Journal of Pediatric Surgery Case Reports |
issn |
2213-5766 |
publishDate |
2015-01-01 |
description |
Familial Mediterranean fever (FMF) is one manifestation of a heritable periodic fever syndrome that is characterized by recurrent attacks of febrile polyserositis, most frequently peritonitis. An FMF abdominal attack is often misdiagnosed as acute appendicitis, a more common cause of an acute abdomen. We report a 14-year-old boy with FMF who developed acute appendicitis during his follow-up. The patient had a several-year history of abdominal pain episodes, and was initially admitted for an acute abdominal attack. The attack resolved over three days, following administration of intravenous fluids, alone. Upon admission, serology revealed elevated serum levels of amyloid A. An analysis of the MEFV gene revealed compound heterozygous Glu148Gln/Ser503Cys, resulting in an FMF diagnosis. Seven months after discharge, the patient was re-admitted with an acute abdomen. Following ultrasonographically diagnosed appendicitis, an appendectomy was performed, and acute phlegmonous appendicitis was confirmed, based on the pathologic examination of the resected specimen. The present case suggests that upon examining an FMF patient with abdominal pain, appendicitis should not be arbitrarily discounted from the differential diagnosis.
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topic |
Familial Mediterranean fever Acute abdomen Appendicitis |
url |
http://www.sciencedirect.com/science/article/pii/S2213576614001596 |
work_keys_str_mv |
AT yoshihikosakurai acuteappendicitisina14yearoldboywithfamilialmediterraneanfever AT takaakimurata acuteappendicitisina14yearoldboywithfamilialmediterraneanfever AT hirohisahirata acuteappendicitisina14yearoldboywithfamilialmediterraneanfever AT takeshimorita acuteappendicitisina14yearoldboywithfamilialmediterraneanfever |
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