Familial Mediterranean Fever Imitating Lupus Flare: A Rare Coexistence of an Autoimmune Disease With an Autoinflammatory Disease

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To the Editor:
Systemic lupus erythematosus (SLE) is a chronic systemic inflammatory disease with myriad of manifestations that follows a relapsing and remitting course. Periodic flares could be a sign of uncontrolled active disease, but very rarely, a flare could be the only sign of another concurrent autoinflammatory disease. Concurrent SLE and familial Mediterranean fever (FMF) is exceptionally rare with handful of case reports and case series in medical literature. Our case is a 41-year-old woman from the Middle East with multiple hospital admissions due to presumed lupus flare. During these episodes, she would present with high fever, polyarthritis, and abdominal pain with elevated inflammatory markers. During 1 admission, given periodic attacks with well-controlled symptoms in between, she was empirically started on colchicine for suspected FMF. Her symptoms were controlled within 48 hours, and she was diagnosed as having concurrent SLE with FMF with significant symptom control on colchicine.
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