“They took out my ovaries,” the 46-year-old woman told the doctor. “And my appendix, and most of my colon. I had several exploratory surgeries where the doctors were just trying to find out what was wrong.” Dr. Thomas Chelimsky listened attentively. “I’ve had, like, 13 surgeries,” the woman reported, her voice edged with sadness. “It’s really been a nightmare.” For the past 23 years, this slender, middle-aged woman was tormented by these intermittent attacks of abdominal pain and fever that lasted sometimes for weeks. None of her doctors had been able to figure out what was causing the strange episodes of devastating illness that prompted all these surgeries and dozens of hospitalizations.
Back in the 1970s when I was a medical student, we used to play a weekly game. At that time, the NEJM had a CPC every week. We would read the title and try to guess the diagnosis. I was only fair, but one of my good friends got the diagnosis at least 3/4 of the time.
I suspected this diagnosis from the title, and would have bet on the diagnosis after reading that first paragraph. Did you?
More great writing from Dr. Sanders. If you have not read her book, why are you waiting?
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Clearly FMF.