FMF and Sjogren's Syndrome Overlap in an Elderly Patient: A Rare Coincidence or a Causal Association?

Abstract

Sixty five-year-old female patient admitted to our clinic with complaint of intermittent fever and abdominal pain for forty years. We learned that she has mouth and eye dryness. Laboratory examination revealed elevated levels of inflammatory parameters. In chest X-ray there was reticular appearance. Then we suspect that rheumatic diseases and serological examination revealed positive ANA and anti-centromere antibodies. Minor salivary gland biopsy was reported as ‘chronic inflammation with focus score 2’. The patient was diagnosed with Sjogren’s syndrome. Because of recurrent abdominal pain with febrile episodes, we suspect of Familial Mediterranean Fever (FMF). We detected homozygous MEFV mutation in genetic mutation analysis and then FMF was diagnosed. In literature, this is the first case, coincidence of Sjogren’s syndrome and FMF, in the geriatric age group and the second case in all age groups.