PERIODIC FEVER: A CASE REPORT

In this report, we describe the case of a twenty-year-old woman, with recurrent fever, accompanied by shaking chills and followed by profuse sweating, bilateral diffuse arthralgia and evidence of focal myositis, associated with elevation of inflammatory markers, pancytopenia, hypocholesterolemia, and hepatosplenomegaly, unresponsive to antibiotic therapy. Subsequently to the exclusion of infectious, autoimmune and neoplastic causes, and because of clinical features and persistence of fever cycles unresponsive to antibiotic therapy, an autoinflammatory periodic fever was suspected. For this reason, the patient was tested for MEFV gene mutation, related to Familial Mediterranean Fever, the well-known and most studied autoinflammatory disease; the patient was negative and a treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) was started, with fever and symptom disappearance, normalization of inflammatory markers and cholesterol levels, and regression of leucopenia and thrombocytopenia. After 5 years of follow-up, the patient was in good general clinical condition with only periodic febrile episodes (2 times a year), with the same clinical and blood chemistry characteristics as before, successfully treated with NSAIDs within 1-2 weeks, and without any appearance of additional symptoms and/or signs of organ damage and/or deterioration of general clinical condition.