Familial Mediterranean Fever Presenting with Recurrent Abdominal Pain without Periodic Fever Following COVID-19
Abstract
Familial Mediterranean fever (FMF) rarely presents without a periodic fever. We report the case of a 16-year-old girl who developed recurrent abdominal pain after coronavirus disease 2019 without fever. The initial evaluation, including endoscopy, was unremarkable, except for mildly elevated fecal calprotectin (182.1 μg/g). On readmission, peritoneal signs, mild pleural effusion, and elevated serum amyloid A (113.9 mg/L) were noted, while the C-reactive protein level remained normal. Colchicine promptly suppressed these attacks. MEFV sequencing revealed a homozygous E148Q mutation, supporting an atypical FMF. Fecal calprotectin and serum amyloid A levels normalized within one month. This case underscores the importance of FMF in post-infectious recurrent abdominal pain and highlights targeted biomarkers and genetics for making a timely diagnosis.
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BibTeX
@article{ueno2026familial,
title = {{Familial Mediterranean Fever Presenting with Recurrent Abdominal Pain without Periodic Fever Following COVID-19}},
author = {Nobuhiro Ueno and Hiromichi Sugai and Suzumi Ujiie and Ryunosuke Hayashi and Kazuki Dai and Manami Hayashi and Yu Kobayashi and Yuki Murakami and Aki Sakatani and Keitaro Takahashi and Tatsuya Dokoshi and Katsuyoshi Ando and Shin Kashima and Kentaro Moriichi and Hiroki Tanabe and Mishie Tanino and Mikihiro Fujiya},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.6541-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/18/65_6541-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Familial Mediterranean Fever Presenting with Recurrent Abdominal Pain without Periodic Fever Following COVID-19
AU - Nobuhiro Ueno
AU - Hiromichi Sugai
AU - Suzumi Ujiie
AU - Ryunosuke Hayashi
AU - Kazuki Dai
AU - Manami Hayashi
AU - Yu Kobayashi
AU - Yuki Murakami
AU - Aki Sakatani
AU - Keitaro Takahashi
AU - Tatsuya Dokoshi
AU - Katsuyoshi Ando
AU - Shin Kashima
AU - Kentaro Moriichi
AU - Hiroki Tanabe
AU - Mishie Tanino
AU - Mikihiro Fujiya
PY - 2026
DA - 2026/09/15
JO - Internal Medicine
DO - 10.2169/internalmedicine.6541-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/18/65_6541-25/_article
AB - Familial Mediterranean fever (FMF) rarely presents without a periodic fever. We report the case of a 16-year-old girl who developed recurrent abdominal pain after coronavirus disease 2019 without fever. The initial evaluation, including endoscopy, was unremarkable, except for mildly elevated fecal calprotectin (182.1 μg/g). On readmission, peritoneal signs, mild pleural effusion, and elevated serum amyloid A (113.9 mg/L) were noted, while the C-reactive protein level remained normal. Colchicine promptly suppressed these attacks. MEFV sequencing revealed a homozygous E148Q mutation, supporting an atypical FMF. Fecal calprotectin and serum amyloid A levels normalized within one month. This case underscores the importance of FMF in post-infectious recurrent abdominal pain and highlights targeted biomarkers and genetics for making a timely diagnosis.
SN - 1349-7235
SN - 0918-2918
ER -