{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:31:07Z","timestamp":1777883467026,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Chronic Disease"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    Familial Mediterranean fever (FMF) is an autoinflammatory disorder with typical early onset and recurrent episodes of fever and serositis. Late-onset FMF, especially presenting as isolated pleural effusion, is rare and often misdiagnosed. We present a case series of six patients over the age of 50 who were diagnosed with FMF after presenting with unexplained pleural effusions. Conventional evaluations failed to identify alternative etiologies, and empirical therapies showed limited success. In all cases,\n                    <jats:italic toggle=\"yes\">MEFV<\/jats:italic>\n                    (Mediterranean fever) gene analysis revealed R202Q mutations, which guided the initiation of colchicine therapy with favorable outcomes. This study highlights the diagnostic challenges posed by atypical FMF presentations and underscores the importance of considering FMF in recurrent serositis, even without systemic inflammation. Early genetic testing and appropriate treatment may reduce unnecessary interventions and improve patient outcomes.\n                  <\/jats:p>","DOI":"10.1177\/27558428251412568","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T08:37:11Z","timestamp":1770367031000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Late-onset familial Mediterranean fever: A case series of missed diagnoses in pleural effusions"],"prefix":"10.1177","volume":"17","author":[{"given":"Angeliki","family":"Miziou","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6933-1068","authenticated-orcid":false,"given":"Ilias E.","family":"Dimeas","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romanos","family":"Ntiloudis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charalampos","family":"Varsamas","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos I.","family":"Gourgoulianis","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.5152\/eurjrheum.2014.006"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e3182060456"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.5505\/respircase.2013.36349"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.5578\/tt.1445"},{"key":"e_1_3_3_6_2","unstructured":"Meyerhoff JM. Familial Mediterranean fever workup: Laboratory studies genetic testing imaging studies. Medscape https:\/\/emedicine.medscape.com\/article\/330284-workup (2024 accessed 7 April 2025)."},{"issue":"7","key":"e_1_3_3_7_2","article-title":"Familial Mediterranean fever in a 28-year-old male presented as a painless massive pleural effusion","volume":"15","author":"Dimeas G","year":"2023","unstructured":"Dimeas G, Dimeas IE, Papacharalampous K, et al Familial Mediterranean fever in a 28-year-old male presented as a painless massive pleural effusion. Cureus 2023; 15(7): e41776.","journal-title":"Cureus"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.46.1828"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-1736"},{"issue":"2","key":"e_1_3_3_10_2","article-title":"An uncommon cause of pleural effusion","volume":"15","author":"Panjwani A","year":"2019","unstructured":"Panjwani A, Salman MR. An uncommon cause of pleural effusion. Breathe (Sheff) 2019; 15(2): e84\u2013e89.","journal-title":"Breathe (Sheff)"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-206567"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(67)90167-2"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0000000000001134"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gene.2012.06.074"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12940"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e3283470293"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2025.03.016"},{"issue":"6","key":"e_1_3_3_18_2","first-page":"3352","article-title":"Therapeutic management of idiopathic recurrent serositis: a retrospective study","volume":"24","author":"Massaro MG","year":"2020","unstructured":"Massaro MG, Rigante D, Sicignano LL, et al Therapeutic management of idiopathic recurrent serositis: a retrospective study. Eur Rev Med Pharmacol Sci 2020; 24(6): 3352\u20133359.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejhg.5200658"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-014-2602-6"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.5606\/ArchRheumatol.2015.4455"},{"key":"e_1_3_3_22_2","first-page":"37","article-title":"A rare cause of fever in an adult: a case of familial Mediterranean fever","volume":"11","author":"Erdem I","year":"2018","unstructured":"Erdem I, Saritas F, Karaali R, et al A rare cause of fever in an adult: a case of familial Mediterranean fever. Int Med Case Rep J 2018; 11: 37\u201340.","journal-title":"Int Med Case Rep J"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-020-06040-y"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-021-05906-1"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-021-04913-4"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2023.05.015"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-022-03233-1"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13206051"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-025-01898-8"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.4103\/JAPTR.JAPTR_22_24"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10528-018-9889-y"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2009.01587.x"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/cimb45010048"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2012.07.019"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-024-05706-1"},{"key":"e_1_3_3_36_2","first-page":"13","article-title":"Familial Mediterranean fever: current perspectives","volume":"9","author":"S\u00f6nmez HE","year":"2016","unstructured":"S\u00f6nmez HE, Batu ED, \u00d6zen S. Familial Mediterranean fever: current perspectives. J Inflamm Res 2016; 9: 13\u201320.","journal-title":"J Inflamm Res"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780401023"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215048"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1159\/000272314"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2022.43.121.33324"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.24953\/turkjped.2023.227"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab128"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208690"}],"container-title":["Sage Open Chronic Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/27558428251412568","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/27558428251412568","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/27558428251412568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:46:51Z","timestamp":1777600011000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/27558428251412568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":42,"alternative-id":["10.1177\/27558428251412568"],"URL":"https:\/\/doi.org\/10.1177\/27558428251412568","relation":{},"ISSN":["2755-8428","2978-1558"],"issn-type":[{"value":"2755-8428","type":"print"},{"value":"2978-1558","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"article-number":"27558428251412568"}}