Inborn error of immunity as the cause of recurrent pericarditis

BMJ Case Rep. 2021 May 19;14(5):e241449. doi: 10.1136/bcr-2020-241449.

Abstract

Familial Mediterranean fever (FMF) is an autoinflammatory disease caused by a pyrin dysfunction, leading to uncontrolled interleukin-1 production that triggers the attacks. Here we report a case of a 36-year-old female patient repeatedly admitted to the cardiology ward with recurrent episodes of pericarditis, with intervals of 1 and 2 months between the episodes. During the attacks, chest pain and fever were the only symptoms. Following the administration of steroids and non-steroidal anti-inflammatory drugs, the patient became afebrile. She also had lymphoma and thyroid carcinoma in anamnesis essential for differential diagnosis. Laboratory tests for infection and autoimmune disease were all negative, and the positron emission tomography-CT scan did not reveal lymphoma relapse. Genetic testing revealed a mutation in the MEFV gene. It is very rare for pericarditis to be the first and only manifestation of FMF.

Keywords: immunology; pericardial disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Familial Mediterranean Fever* / complications
  • Familial Mediterranean Fever* / drug therapy
  • Familial Mediterranean Fever* / genetics
  • Female
  • Fever
  • Humans
  • Mutation
  • Neoplasm Recurrence, Local
  • Pericarditis* / etiology
  • Pyrin / genetics

Substances

  • MEFV protein, human
  • Pyrin