Familial Mediterranean fever presenting as recurrent myocarditis: a case report

Abstract Background Recurrent myocarditis is an uncommon clinical entity, and determining its underlying etiology can be challenging. This report describes a rare case of recurrent myocarditis secondary to an autoinflammatory condition. Case presentation A seven-year-old previously healthy boy presented with recurrent episodes of chest pain and elevated cardiac troponin levels, initially consistent with viral myocarditis. During evaluation for the second episode, elevated serum amyloid A (SAA) levels were detected, prompting further investigation. Genetic testing identified a heterozygous SLC40A1 variant, and the clinical findings fulfilled diagnostic criteria for Familial Mediterranean Fever (FMF). The patient was commenced on colchicine therapy, which resulted in normalization of SAA levels and complete resolution of recurrent myocarditis. Conclusions This case highlights FMF as a rare but important cause of recurrent myocarditis in children. Autoinflammatory disorders should be considered when typical infectious etiologies are excluded. Early recognition and initiation of colchicine therapy may lead to full recovery and prevent recurrence.