ÖZKarın ağrısı, çocuklarda sık görülen bir yakınmadır, cerrahi ve cerrahi dışı nedenleri mevcuttur. Ailesel Akdeniz ateşi, cerrahi dışı nedenler arasında yer almakta ve ateş yüksekliği, inflamatuar serozit ile seyretmektedir. Uzamış febril miyalji sendromu, Ailesel Akdeniz ateşi ile birlikte görülebilmektedir ve ilk kez 1994 yılında tanımlan-mıştır. Uzamış febril miyalji sendromunda yüksek ateş, miyalji, karın ağrısı, artrit/ artralji ve döküntüler görülebilmektedir. Bu makalede ateş yüksekliği ve karın ağrısı ile başvuran, takibinde eklenen kas ağrıları ile ilk atağı uzamış febril miyalji ve Ailesel Akdeniz ateşi tanısı alan bir olgu sunulmuştur. Uzamış febril miyalji sendromunun, Ailesel Akdeniz ateşinde atipik klinik belirtilerden biri olduğu ve ilk başvuruda görü-lebileceği vurgulanmak istenmiştir. Anahtar kelimeler: Ailesel Akdeniz ateşi, karın ağrısı, uzamış febril miyalji ABSTRACTAbdominal pain is a common complain in children which is caused by surgical and non-surgical reasons. Familial meditterian fever is one of the common non-surgical reasons and the most common syptoms are fever and inflammatory serositis. But one of the rare form is protracted febrile myalgia defined first time in 1944. This form may coexist with fever, myalgia, abdominal pain, athritis and athralgia. In this article, we presented a case with fever and abdominal pain, followed by muscular pain diagnosed as a protracted febrile myalgia syndrome and Familial Mediterranean Fever. It is emphasized that the prolonged febrile myalgia syndrome is one of the atypical clinical manifestations in the Familial Mediterranean Fever and may be seenat the first admission.

Symptoms of infantile inflammatory bowel disease (I-IBD) can be life-threatening and associated with poor prognosis. The presence of Mediterranean fever (MEFV) gene mutations play an important role in treatment of I-IBD. In this article, we describe a case of I-IBD with a resistant fistula, in which remission occurred following colchicine therapy. The patient was a six-month-girl with complaints of bloody diarrhea and a perianal abscess of three months duration. Laboratory tests revealed elevated inflammatory parameters, hypoalbuminemia, and anemia. Results of repeated viral, bacterial and parasitic analyses were negative. Endoscopic and histopathological examinations confirmed a diagnosis of I-IBD. Although diarrhea episodes decreased following intensive conventional treatment with immunosuppressive therapy and anti-tumor necrosis factor, the perianal abscess and fistula did not resolve. Molecular genetic analysis to identify causes of infantile disease revealed the MEFV gene mutation. Thus, colchicine was added to the treatment regimen. Following treatment with colchicine, defecation returned to normal, and the fistula resolved. The MEFV gene mutation should be investigated in children with infantile colitis and resistant fistulas, particularly in Mediterranean countries. In patients with infantile colitis who have the MEFV gene mutation, colchicine treatment may be an alternative to intensive immunosuppressive therapy.

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