OBJECTIVES: To study the frequency and clinical patterns
of myalgia in a defined group of children with familial
Mediterranean fever (FMF).
METHODS: A prospective 4-year (September 1995-September
1999) study of children with FMF seen in the pediatric FMF
clinic of Jordan University teaching hospital. Diagnosis of FMF
was made according to published criteria. Once the diagnosis of
FMF and myalgia was made, details about myalgia were collected
by interview with the child and his/her parents and entered into
a special study form.
RESULTS: Of 264 children with FMF seen over the study
period, 65 (25%) developed myalgia. Three clinical patterns of
myalgia were identified: the spontaneous pattern, the
exercise-induced pattern, and the protracted febrile myalgia
syndrome (PFMS), seen in 8%, 81%, and 11% of patients,
respectively. The three patterns differed in the severity of
pain, height of fever, and duration of the episode. In 33
children with the exercise-induced myalgia, in which response to
colchicine could be reliably assessed, a favorable response was
achieved in 97%. Three children with the PFMS had a dramatic
response to corticosteroids.
CONCLUSIONS: Myalgia in children with FMF is common and
can follow three different clinical patterns.
Department of Pediatrics, Faculty of Medicine, University of