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Familial Mediterranean fever in which Crohn's disease was suspected: a case report.
[familial mediterranean fever]
Familial
Mediterranean
fever
is
a
hereditary
autoinflammatory
disease
,
mainly
characterized
by
periodic
fever
and
serositis
.
The
level
of
awareness
about
familial
Mediterranean
fever
is
far
from
sufficient
,
and
it
is
assumed
that
there
may
be
many
patients
with
this
disease
who
are
under
observation
without
an
accurate
diagnosis
.
A
30
-
year
-old
Japanese
man
presented
to
us
with
a
few
years
'
history
of
recurrent
episodes
of
fever
,
abdominal
pain
and
diarrhea
.
He
often
visited
a
hospital
when
the
attacks
occurred
;
however
,
acute
enteritis
was
diagnosed
each
time
,
and
the
symptoms
resolved
spontaneously
within
a
few
days
.
When
he
noticed
a
shortening
of
the
interval
between
the
attacks
,
he
visited
the
hospital
again
.
Upper
endoscopy
and
colonoscopy
performed
at
this
hospital
revealed
no
significant
abnormal
findings
.
He
was
then
referred
to
our
hospital
under
the
suspicion
of
a
small
intestinal
disease
.
Abdominal
computed
tomography
revealed
wall
thickening
and
increased
density
of
the
mesenteric
adipose
tissue
in
the
jejunum
,
which
led
us
to
suspect
Crohn
's
disease
.
Oral
double
-balloon
enteroscopy
was
performed
;
because
this
revealed
only
mild
mucosal
edema
in
the
jejunum
,
Crohn
's
disease
was
considered
to
be
highly
improbable
.
Based
on
the
patient
's
clinical
course
,
we
suspected
familial
Mediterranean
fever
.
As
the
Livneh
criteria
for
familial
Mediterranean
fever
were
satisfied
,
the
patient
was
started
on
oral
colchicine
for
the
purpose
of
diagnostic
treatment
.
A
definitive
diagnosis
of
familial
Mediterranean
fever
was
then
made
based
on
the
detection
of
a
mutation
of
the
Mediterranean
fever
gene
.
A
marked
reduction
in
the
frequency
of
attacks
was
observed
in
response
to
colchicine
treatment
.
Although
Crohn
's
disease
may
be
considered
first
in
the
differential
diagnosis
of
young
patients
presenting
with
periodic
fever
,
abdominal
pain
and
diarrhea
,
the
possibility
of
familial
Mediterranean
fever
should
also
be
borne
in
mind
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated