Familial Mediterranean fever should be considered in the differential diagnosis of recurrent acute pericarditis, as it responds well to targeted therapy with colchicine.
Colchicine response in recurrent pericarditis may indicate FMF; hypothesis-generating and requires prospective validation.
A 56-year-old man was admitted to our hospital due to periodic episodes of acute pericarditis. These episodes occurred monthly along with a high fever and elevation of the C-reactive protein (CRP) level. The patient became afebrile and his CRP level decreased following the administration of a non-steroidal anti-inflammatory drug. A mutation analysis revealed the heterozygote of the familial Mediterranean fever (FMF) gene (E84K, G304R). This finding confirmed our diagnosis, and we treated the patient with colchicine. He responded to treatment and has been visiting our hospital without disease recurrence. FMF should be included in the differential diagnosis of repeated episodes of pericarditis.
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Yoshioka et al. (2014) studied this question.
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