1. INTRODUCTION
Familial
Mediterranean fever (FMF) is an autoinflammatory disease, associated
with mutations in the Mediterranean fever (MEFV) gene with an autosomal
recessive pattern of inheritance, and mainly affects populations of
eastern Mediterranean descent1. It is characterized by
recurrent self-limited attacks of fever and serosal inflammation as well
as the development of amyloidosis 1,2. Patients with
FMF may also have non-amyloid renal involvement including typical acute
post-streptococcal glomerulonephritis (APSGN) 3. APSGN
is an important non-suppurative, immunologically mediated complication
of streptococcal infection4and presents with the
sudden onset of gross hematuria, edema, and hypertension with variable
degrees of renal impairment5. Vasculitic diseases such
as polyarteritis nodosa (PAN) also affect the kidneys in
FMF6. PAN is a primary multisystem inflammatory
disorder characterized by acute necrotizing vasculitis of the small and
medium-sized visceral arteries and their branches with a pauci-immune
pattern 7,8, and it may develop in children with FMF7,9. Here, we report a previously healthy patient,
newly diagnosed with FMF and with co-existing APSGN and PAN.