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Volume 34, Issue 4, December 2023



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Mediterr J Rheumatol 2023;34(4):550-4
A Case of Protracted Febrile Myalgia Syndrome with Atypical Course and Severe Asymmetric Loss of Muscle Strength
Authors Information

1Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey

2Department of Internal Medicine, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey

3Department of Physical Medicine and Rehabilitation, University of Health Sciences Istanbul Physical Medicine and Rehabilitation Hospital, Istanbul, Turkey

R Deniz, I Gerdan, D Sevinç Özgür, B Karaalioğlu, G Akkuzu, F Yıldırım, C Bes

Abstract

Protracted febrile myalgia syndrome (PFMS) is a rare form of familial Mediterranean fever (FMF) characterised by prolonged myalgia. The duration of PFMS is much longer than a typical 2-5-day attack familial Mediterranean fever and lasts for 2-6 weeks until they treated with corticosteroids. Colchicine is not effective for control of PFMS’s attacks. The attacks typically resolve with corticosteroid and/or IL-1 receptor blockers. Herein, we present a young adult without typical familial Mediterranean fever clinical features but presenting with atypical course and severe asymmetric muscle strength loss. Thigh magnetic resonance imaging confirmed inflammation and oedema and muscle biopsy showed no pathological findings. Electromyography revealed myopathic findings during attack-period, despite normal results in attack-free study. The patient was treated successfully with anakinra and remarkable rapid recovery in both muscular findings and acute phase reactants were observed. PFMS should be considered even in the absence of apparent FMF attack pattern and in the presence of unexpected severe muscle weakness, especially in areas endemic for FMF and long-lasting myalgia attacks.

Cite this article as: Deniz R, Mandacı A, Gerdan I, Özgür DS, Karaalioğlu B, Akkuzu G, Yıldırım F, Bes C. A Case of Protracted Febrile Myalgia Syndrome with Atypical Course and Severe Asymmetric Loss of Muscle Strength. Mediterr J Rheumatol 2023;34(4):550-4

Article Submitted: 19 Dec 2022; Revised Form: 18 Jan 2023; Article Accepted: 01 Feb 2023; Available Online: 30 Jul 2023

This work is licensed under a Creative Commons Attribution 4.0 International License.

©2023 The Author(s).

https://doi.org/10.31138/mjr.300723.aco