Transient and Recurrent Pulmonary Infiltrations Associated with Familial Mediterranean Fever

Abstract

Chest symptoms and pleural effusion due to serositis in familial Mediterranean fever (FMF) are occasionally misdiagnosed as acute pneumonia. However, the actual pulmonary involvement of FMF is extremely rare. A 67-year-old man was referred to our hospital due to repeated and transient anterior chest pain. Chest images revealed a moderate amount of pericardial fluid, slight bilateral pleural effusion, and infiltrations in both lower lung lobes. Colchicine treatment without antibiotics rapidly improved these symptoms and findings. Pericarditis, pleurisy and the response to colchicine indicated FMF. FMF should be considered as a causative disease of pulmonary infiltrations, especially if it occurs repeatedly.

Keywords: colchicine treatment; cryptogenic organizing pneumonia; familial Mediterranean fever; pulmonary infiltrations.

Figure 1.

Time course of chest X-ray (A, D) and computed tomography (CT) (B, E: mediastinal window, C, F: lung parenchyma window) images (A-C: on admission, D: three days later, E, F: 12 days later). (A-C) An enlarged heart shadow, moderate amount of pericardial fluid, very slight bilateral pleural effusion, and infiltrations in both lower lung lobes. (D-F) Improvement in the enlarged heart shadow, pericardial fluid, pleural effusion, and lung infiltrations.

Figure 2.

Chest X-ray (A, D) and computed tomography (CT) (B: mediastinal window, C: lung parenchyma window) images (A-C: on admission, D: three days later) three years earlier. (A-C) An enlarged heart shadow, small amount of pericardial fluid, and infiltrations in both lower lung lobes. (D) Improvement in the enlarged heart shadow.