This is probably a very long stretch, but FMF (familial mediterranean fever)
can present like this.
The pt does not have to be febrile during episodes, but abdominal pain is
As you know, it is polyserositis prevalent among people of Italian, Sephardi
Jewish, Arab, and Armenian descent.
FHx is usually notable for other such cases and for people taking Colchicine
for something other than gout.
Exam may show HSM, diffuse erythematous macular rash, joint effusions.
Hematuria may be seen with renal involvement.
Labs show elevated ESR/CRP (which is, obviously, not specific).
My 2c. :-)
Michael Tsifansky, MD
University of Minnesota, Pediatrics
420 Delaware St. SE, Box 391 - Mayo
Minneapolis, MN 55454
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