Evaluation of Familial Mediterranean Fever with Pleural Effusions

Objective: We aimed to evaluate the frequency of Familial Mediterranean Fever (FMF) related pleural effusions in the patients who hospitalized for pleural effusion. Methods: 123 adult patients with pleural effusion were included in the study. In addition to demographic data clinical, radiological/scintigraphic imaging , bronchoscopical findings, cytological, histopathological, biochemical analysis of the pleural fluid and pleural tissue were evaluated. Results: Female/male ratio was 11/112 and mean-age was 46.57 (16-75). 69.9% of the effusion was benign (n=86) and 22.7% was malignant (n=28). The most frequent etiological factor was tuberculosis (30.1%). However 5.6% (n=7) of pleural effusions were undiagnosed. FMF was the cause of pleuritis in two (1.6%) male patients. Case I was 35 years old and Case II was 59 years old. Although, in the Case I amyloidosis was detected previously in his renal biopsy, colchicine treatment hadn’t been started. Case II had been hospitalized in our hospital four-times in the past, FMF was firstly diagnosed in his last hospitalization. Their sedimentation rates were 120 and 110 mm/hr, respectively. Fibrinogen levels were 1125 mg/dl in Case I and 690 mg/dl in Case II during attack and 260 mg/dl and 150 mg/dl after attack, respectively. Conclusion: Undiagnosed pleural effusions are problematic cases for the physicians. However, FMF should be kept in mind in case of undiagnosed and/or recurrent pleuritis, particularly in the areas where disease is prevelant. The early diagnosis will prevent the patients from further invasive diagnostic procedures.