[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-458302-105":59,"doc-detail-458302-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","familial-mediterranean-fever-a-diagnostic-and-therapeutic-challenge-case-report","Familial Mediterranean Fever: A Diagnostic and Therapeutic Challenge - Case Report","","Recurrent pericarditis is a complex, disabling condition marked by repeated pericardial inflammation after an initial acute trigger. It creates major diagnostic and therapeutic uncertainty because causes range from autoimmune disease and infections to malignancy and autoinflammatory syndromes. Although many cases are labeled idiopathic and often thought to be post-viral or immune mediated, evidence suggests some patients have monogenic autoinflammatory disorders. A steroid-responsive case with fever and elevated markers illustrates the need to consider familial Mediterranean fever and related hereditary periodic fever syndromes, supporting targeted long-term remission strategies and steroid sparing.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/familial-mediterranean-fever-a-diagnostic-and-therapeutic-challenge-case-report/458302/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/familial-mediterranean-fever-a-diagnostic-and-therapeutic-challenge-case-report/458302.png","ImageObject",300,407,{"name":92,"@type":93},"Damian","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What makes recurrent pericarditis difficult to diagnose and treat?","Question",{"text":112,"@type":113},"Recurrent pericarditis involves a broad differential diagnosis, including autoimmune, infectious, neoplastic, and autoinflammatory causes, so identifying the underlying driver is often challenging.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why is familial Mediterranean fever important in this case?",{"text":117,"@type":113},"The patient had steroid-responsive recurrent pericarditis with episodic fever and elevated inflammatory markers, with conventional infectious and autoimmune work-ups excluded, leading to a probable FMF diagnosis after genetic testing.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatments and therapeutic implications are highlighted?",{"text":121,"@type":113},"Targeted therapies such as colchicine and interleukin-1 blockade (e.g., anakinra, rilonacept) are discussed as options that may provide long-term remission and reduce reliance on steroids.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458302,1791158945,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},137451208677,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Review began 11/14/2025  \nReview ended 12/03/2025  \nPublished 12/08/2025  \n© Copyright 2025  \nSia. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98777  \nOpen Access Case Report  \nFamilial Mediterranean Fever: A Diagnostic and Therapeutic Challenge  \nRobin Sia 1  \n1. Rheumatology, Northern Hospital, Epping, AUS  \nCorresponding author: Robin Sia, [robinsiawaijen@gmail.com](robinsiawaijen@gmail.com)  \nAbstract  \nRecurrent pericarditis is a complex and often debilitating clinical entity characterized by repeated episodes of pericardial inflammation following an initial acute insult. The condition poses a significant diagnostic and therapeutic challenge, as its underlying causes span a wide spectrum of etiologies, including autoimmune disorders (such as systemic lupus erythematosus and rheumatoid arthritis), infectious processes (notably viral, bacterial, or tuberculous), neoplastic involvement, and a growing recognition of autoinflammatory mechanisms. While the majority of recurrent pericarditis cases are deemed idiopathic, presumed to reflect a post-viral or immune-mediated phenomenon, there is increasing evidence that a subset of patients may have underlying monogenic autoinflammatory syndromes. We present the case of a middle-aged woman with recurrent, steroid-responsive pericarditis accompanied by episodic fever and elevated inflammatory markers, in whom conventional infectious and autoimmune causes were excluded. Her clinical course raised suspicion of an underlying autoinflammatory mechanism, highlighting the importance of considering familial Mediterranean fever (FMF) and other hereditary periodic fever syndromes in patients with otherwise unexplained, relapsing pericardial disease.  \nCategories: Rheumatology, Infectious Disease, Allergy/Immunology  \nKeywords: autoinflammatory disease, familial mediterranean fever, fmf, periodic fever syndrome, recurrent pericarditis, serositis  \nIntroduction  \nRecurrent pericarditis represents a challenging clinical entity characterised by repeated episodes of pericardial inflammation following an initial event, often leading to significant morbidity and prolonged corticosteroid exposure. The condition has a broad differential diagnosis, encompassing autoimmune, infectious, neoplastic, and autoinflammatory causes. While most cases are classified as idiopathic, presumed viral, or immune-mediated, there is increasing recognition of an underlying autoinflammatory component in a subset of patients previously considered idiopathic. In particular, hereditary periodic fever syndromes such as familial Mediterranean fever (FMF), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), and mevalonate kinase deficiency (MKD) have been implicated in recurrent pericardial inflammation, often in the absence of overt serositis elsewhere. We report the case of a middle-aged woman with steroid-responsive recurrent pericarditis associated with recurrent fevers and elevated inflammatory markers, in whom a conventional infectious, neoplastic, and autoimmune work-up was unrevealing. However, eventually a probable diagnosis of FMF was made following genetic testing. This case underscores the importance of recognizing autoinflammatory causes of pericarditis, as diagnosis has critical therapeutic implications, with targeted therapies such as colchicine and interleukin-1 blockade (e.g., anakinra, rilonacept) offering potential for long-term remission and steroid-sparing benefit.  \nCase Presentation  \nA 55-year-old woman with a history of hypothyroidism on levothyroxine presented with recurrent episodes of sharp, pleuritic chest pain in keeping with acute pericarditis associated with intermittent fever and hypotension. She was first admitted in July 2025 with acute pericarditis, w","cbCaipEYJaSNtNEe","https://ap.wps.com/l/cbCaipEYJaSNtNEe","pdf",1889174,"English","# Abstract\n# Introduction\n# Case Presentation\n# How to cite this article\n# Figures","[{\"question\":\"What makes recurrent pericarditis difficult to diagnose and treat?\",\"answer\":\"Recurrent pericarditis involves a broad differential diagnosis, including autoimmune, infectious, neoplastic, and autoinflammatory causes, so identifying the underlying driver is often challenging.\"},{\"question\":\"Why is familial Mediterranean fever important in this case?\",\"answer\":\"The patient had steroid-responsive recurrent pericarditis with episodic fever and elevated inflammatory markers, with conventional infectious and autoimmune work-ups excluded, leading to a probable FMF diagnosis after genetic testing.\"},{\"question\":\"What treatments and therapeutic implications are highlighted?\",\"answer\":\"Targeted therapies such as colchicine and interleukin-1 blockade (e.g., anakinra, rilonacept) are discussed as options that may provide long-term remission and reduce reliance on steroids.\"}]","Familial Mediterranean Fever: A Diagnostic and Therapeutic Challenge - Case Report | PDF",1790752523,13]