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doi:10.1378/chest.07-1736
(Chest. 2008; 133:999-1001)
© 2008 American College of Chest Physicians
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Unilateral Lymphocytic Pleuritis as a Manifestation of Familial Mediterranean Fever*

Stamatis Katsenos, MD; Charalampos Mermigkis, MD; Kostas Psathakis, MD; Kostas Tsintiris, MD; Vlassios Polychronopoulos, MD, FCCP; Panagiotis Panagou, MD; Kostas Ritis, MD and Richard W. Light, MD, FCCP

* From the Department of Pneumonology (Drs. Katsenos, Mermigkis, Psathakis, Tsintiris, and Panagou), Army General Hospital of Athens, Athens, Greece; Third Pulmonary Department (Dr. Polychronopoulos), Sismanoglio General Hospital, Athens, Greece; First Division of Internal Medicine (Dr. Ritis), Democritus University of Thrace, Alexandroupolis, Greece; and Division of Allergy, Critical Care, Pulmonary Disease, and Critical Care Medicine (Dr. Light), Vanderbilt University, Nashville, TN.

Correspondence to: Stamatis Katsenos, MD, 3 Ierarhou Panaretou St, 45445, Ioannina, Greece; e-mail: skatsenos{at}yahoo.gr

Familial Mediterranean fever (FMF) is an autosomal recessive disease affecting predominantly populations surrounding the Mediterranean basin. It is the most prevalent hereditary periodic fever syndrome characterized mainly by recurrent and short attacks of fever and serositis (pleuritis, arthritis, peritonitis). Unilateral polymorphonuclear exudative pleuritis associated with fever has been reported as the solitary manifestation of the first FMF attack, in < 10% of patients. This case study describes a 30-year-old Greek man with recurrent episodes of lymphocytic exudative pleuritis associated with fever. After a thorough workup (clinical criteria and molecular genetic testing identifying homozygosity polymorphisms of the FMF gene), the diagnosis of FMF was established. Treatment with colchicine, 2 mg/d, eliminated FMF attacks. To our knowledge, this is the first well-documented case report of a patient with FMF presenting with a lymphocytic exudative pleural effusion.

Key Words: familial Mediterranean fever • fever • lymphocytic pleural effusion






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