老年患者FMF和干燥综合征重叠:罕见的巧合还是因果关系?

G. S. Aycicek, Ta Cetiner, G. Arık, B. Canbaz, F. Sumer, O. Kara, H. Kucuk, Z. Ulger
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摘要

65岁女性患者因间歇性发热和腹痛入院40年。我们得知她有口干和眼干。实验室检查显示炎症参数水平升高。胸部X线片可见网状结构。然后我们怀疑风湿性疾病和血清学检查显示ANA和抗着丝粒抗体阳性。小唾液腺活检报告为“慢性炎症,病灶评分2”。患者被诊断为干燥综合征。由于反复腹痛伴发热,我们怀疑是家族性地中海热(FMF)。我们在基因突变分析中检测到纯合的MEFV突变,然后诊断出FMF。在文献中,这是老年组中第一例干燥综合征和FMF同时发生的病例,也是所有年龄组中的第二例。
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FMF and Sjogren's Syndrome Overlap in an Elderly Patient: A Rare Coincidence or a Causal Association?
Sixty five-year-old female patient admitted to our clinic with complaint of intermittent fever and abdominal pain for forty years. We learned that she has mouth and eye dryness. Laboratory examination revealed elevated levels of inflammatory parameters. In chest X-ray there was reticular appearance. Then we suspect that rheumatic diseases and serological examination revealed positive ANA and anti-centromere antibodies. Minor salivary gland biopsy was reported as ‘chronic inflammation with focus score 2’. The patient was diagnosed with Sjogren’s syndrome. Because of recurrent abdominal pain with febrile episodes, we suspect of Familial Mediterranean Fever (FMF). We detected homozygous MEFV mutation in genetic mutation analysis and then FMF was diagnosed. In literature, this is the first case, coincidence of Sjogren’s syndrome and FMF, in the geriatric age group and the second case in all age groups.
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