A Peculiar Case of Abdominal Pain in an Eleven Years Old Child

An 11 years old boy presented to us with three weeks history of severe colicky abdominal pain and dark colored urine. It would not be relieved by anti-colic medication. This attack of abdominal pain was associated with dark colored urine with hypertension and anemia. There was a past history of recurrent abdominal pain that started at the age of 3 years old. This Pain occurred in attacks that would last for days, these attacks were afebrile not associated with diarrhea, vomiting, rash, jaundice or dark urine.

Initially these attacks would be relieved by Parasympatholytic drugs, the patient then would have free months then the pain would recur. Investigations showed Hb 9 mg/dl, ESR 70, CRP 55, negative ANA, negative anti DNAse, urine RBCS over 100, normal HB electrophoresis, the patient was MEFV gene mutation double heterozygous. It was atypical case of familial medientranian fever.

Author(s):

Sahbaa Fehr

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