Usefulness of Small Intestinal Endoscopy in a Case of Adult-onset Familial Mediterranean Fever Associated with Jejunoileitis

Takashi Kitade; Noriyuki Horiki; Masaki Katsurahara; Toshiaki Totoki; Tetsuro Harada; Shunsuke Tano; Reiko Yamada; Yasuhiko Hamada; Hiroyuki Inoue; Kyosuke Tanaka; Esteban C Gabazza; Hiroyuki Hayashi; Masanori Tanaka; Yoshiyuki Takei

doi:10.2169/internalmedicine.54.3690

CASE REPORTS

Usefulness of Small Intestinal Endoscopy in a Case of Adult-onset Familial Mediterranean Fever Associated with Jejunoileitis

Takashi Kitade, Noriyuki Horiki, Masaki Katsurahara, Toshiaki Totoki, Tetsuro Harada, Shunsuke Tano, Reiko Yamada, Yasuhiko Hamada, Hiroyuki Inoue, Kyosuke Tanaka, Esteban C Gabazza, Hiroyuki Hayashi, Masanori Tanaka, Yoshiyuki Takei

Author information

Takashi Kitade
Department of Endoscopy, Mie University Hospital, Japan
Noriyuki Horiki
Department of Endoscopy, Mie University Hospital, Japan
Masaki Katsurahara
Department of Endoscopy, Mie University Hospital, Japan
Toshiaki Totoki
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Japan
Tetsuro Harada
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Japan
Shunsuke Tano
Department of Endoscopy, Mie University Hospital, Japan
Reiko Yamada
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Japan
Yasuhiko Hamada
Department of Endoscopy, Mie University Hospital, Japan
Hiroyuki Inoue
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Japan
Kyosuke Tanaka
Department of Endoscopy, Mie University Hospital, Japan
Esteban C Gabazza
Department of Immunology, Mie University Graduate School of Medicine, Japan
Hiroyuki Hayashi
Department of Pathology, Yokohama Municipal Citizen's Hospital, Japan
Masanori Tanaka
Department of Pathology and Laboratory Medicine, Hirosaki City Hospital, Japan
Yoshiyuki Takei
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Japan

Keywords: familial Mediterranean fever, capsule endoscopy, double balloon endoscopy, endoscopy, neutrophil infiltration, infliximab

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 11 Pages 1343-1347

DOI https://doi.org/10.2169/internalmedicine.54.3690

Details

Abstract

A 66-year-old Japanese man consulted our institution due to paroxysmal and repetitive bouts of fever and abdominal pain that had persisted for more than one week. Capsule and double-balloon endoscopy (DBE) showed petal-shaped mucosal redness with white hemming in the jejunum and ileum, and histopathology of the biopsy specimens revealed villous atrophy and cryptitis with extensive severe neutrophil infiltration. A genetic examination disclosed compound heterozygous MEFV mutations (E84K, P369S), and familial Mediterranean fever was diagnosed. Treatment with colchicine and infliximab was very effective in inducing the complete disappearance of symptoms and normalization of the endoscopic findings. To the best of our knowledge, this is the first report to describe the findings of small intestinal endoscopic images obtained using capsule and DBE.

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