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Familial Mediterranean fever (FMF) is an autosomal recessive disorder that affects primarily Jews, Armenians, Turks, and Arabs. It is characterised by recurrent, self limited attacks of fever accompanied by inflammation of the peritoneal, synovial, and pleural surfaces.1 Pericardial involvement is a well known (0.7–1.4%) but rare feature of the disease.2,3 Our initial observation of two patients who had recurrent pericarditis as a sole manifestation of FMF4 has led us to suggest that pericardial inflammation is more prevalent than generally believed. Since echocardiography is a non-invasive and sensitive tool for the detection of pericardial effusion, we undertook an echocardiographic study to assess the exact frequency of pericardial effusions during attacks of FMF.
PATIENTS AND METHODS
Two dimensional, M mode, and Doppler echocardiographic examinations were performed during 55 consecutive FMF attacks in 42 patients (15 female, 17 male). Echocardiographic study was carried out by one of the authors (ET or SA) and reviewed by the other one, who was aware of the diagnosis of FMF but unaware of the presence or absence of chest pain. Typical attacks of FMF consisted of fever and serositis including peritoneum, synovium, and pleura lasting 1–4 days. Attacks of FMF were recurrent and self limited. FMF was diagnosed according to established clinical criteria or molecular analysis when appropriate (in 37 patients).1 None of the patients had …