Treatment with Colchicine in an Undiagnosed 45-year-old Female Patient with Diffuse Abdominal and Flank Pain for more than 5 years

Abstract

A 45-year-old female patient living abroad has severe abdominal and flank pain that persists for more than 5 years and recurs several times a month. She never had a fever when the pain developed. For more than 5 years, no pathology was detected in the patient's blood and urine tests, abdominal ultrasound and computed tomography. Analgesics and antispasmodics used for the patient's pain are not effective at all, and the patient is relieved with narcotic analgesics in every painful attack. Finally, the patient who came to our hospital with severe abdominal and flank pain was first relieved with narcotic analgesics due to her detailed history, then blood, urine tests and abdominal ultrasound were performed, but no pathology was detected. Considering the possibility of atypical FMF, colchicine treatment was considered for the patient. With the patient's approval, oral 0.6 mg of colchicine was started 3 times a day and the patient were followed up. At the controls 1 week, 1 month and 3 months later, it was observed that the patient did not have any painful attacks, and no colchicine-related side effects were observed. FMF not only progresses with painful attacks, but also amyloid A (AA) amyloidosis, which is a fatal complication, can affect the kidneys and cause kidney failure. Therefore, colchicine treatment should be tried before narcotic analgesics in all patients with abdominal and flank pain who have normal examination findings, laboratory tests and radiological imaging findings, and even negative FMF gene analysis.