Familial Mediterranean fever with chronic ascites: a case report and a review of literature

Familial Mediterranean fever (FMF) is an autosomal recessive inflammatory disease especially seen in Turks, Sephardic Jews, Armenians, and Arabs. Peritoneal and pleural inflammation, arthritis, erysipelas-like erythema, and arthralgia are well-known features of FMF. A small amount of peritoneal fluid collection can be seen during peritoneal attacks in FMF patients, but chronic ascites is a rather rare complication. We herein report a female FMF patient who developed chronic ascites. She was compound heterozygote for M694V/M680I mutation of the MEFV gene. Aspiration of the ascites fluid revealed a small amount of erythrocytes and mesothelial cells. After dose adjustment of colchicine the amount of ascites decreased. In conclusion, FMF should be considered in the differential diagnosis of chronic ascites in populations where the disease is endemic.