Which physical findings are characteristic of familial Mediterranean fever (FMF)?

Updated: Apr 07, 2020
  • Author: John O Meyerhoff, MD; Chief Editor: Herbert S Diamond, MD  more...
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Temperatures can reach as high as 40°C (104°F), but, in most cases, rapid defervescence occurs within 12 hours. Other physical findings of FMF depend mostly on the serosal surface involved, as follows:

  • A boardlike or surgical abdomen is present with typical findings of peritonitis (ie, abdominal tenderness, decreased bowel sounds). Splenomegaly is common in response to the inflammation. Patients with pleural involvement may have shallow breathing and chest-wall tenderness, but friction rubs are rare.

  • Joints show typical inflammatory changes, with warmth, erythema, or swelling.

  • A well-demarcated, erythematous, warm rash, particularly below the knee, ranging from 15-50 cm2 may develop and may be accompanied by swelling.

  • Patients with painful myalgia syndrome may have tender muscles.

  • Female patients with symptoms mimicking pelvic inflammatory syndrome may experience pain on cervical motion and may develop tender, enlarged ovaries.

  • Unilateral, erythematous, and tender swelling of the scrotum occurs in scrotal attacks. The typical manifestations of Behçet disease and Henoch-Schönlein purpura may be observed.

  • Amyloidosis is usually asymptomatic, with hypertension reported in 35% of patients late in the disease. Renal vein thrombosis may develop and manifests as loin pain.

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