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Armenian&#44; Arab and Jewish populations&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> In this paper we mentioned about a patient with sarcoidosis who was monitored for 10 years was diagnosed with FMF in addition to sarcoidosis as a result of the examination of her recent increasing complaints&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">50 years old female patient who was diagnosed with sarcoidosis 10 years ago was admitted to our rheumatology clinic with complaints of fatigue&#44; recurrent fever&#44; dry cough&#44; and arthralgia&#46; During her examination&#44; she described recurrent abdominal pain and fever attacks which occur since her childhood&#46; There is no known feature in her family history and she does not identify FMF in her family&#46; Her medical history revealed that she was examined for a cough and she had a diagnosis of sarcoidosis supported with lymphatic gland biopsy 10 years ago&#46; After 2 years of corticosteroid treatment&#44; her disease restrained&#44; she discontinued to treatment with medication and patient was not present for the subsequent control sessions&#46; Patient&#39;s physical examination showed&#59; 38&#46;5<span class="elsevierStyleHsp" style=""></span>&#176;C fever&#44; sensitivity in both ankles and hip joints and negative results for FABER&#40;Flexion&#44; ABduction&#44; External Rotation&#41; and FADIR&#40;Flexion&#44; ADduction&#44; Internal Rotation&#41; tests&#46; In her systemic examination&#44; rough lung sounds were determined during auscultation&#46; There is palpable lymphadenopathy in her right axillar area&#46; In laboratory tests&#59; fasting blood glucose&#44; liver&#44; and renal functions were normal&#46; CBC&#44; thyroid function tests and routine urinalysis were normal&#46; Acute phase reactants were investigated&#59; C-reactive protein &#40;CRP&#41; was 4&#46;03<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;normal 0&#8211;0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&#44; and sedimentation rate was 43<span class="elsevierStyleHsp" style=""></span>mm&#47;h &#40;normal 0&#8211;20&#41;&#46; In serological tests&#44; negative results for RF&#44; ANA&#44; anti-CCP&#44; ANCA&#44; anti-dsDNA was determined&#46; Hepatitis markers &#40;HBV&#44; HCV&#44; HIV&#41; was normal&#46; Serum ACE level was high &#40;87<span class="elsevierStyleHsp" style=""></span>U&#47;L&#59; normal range&#58; 8&#8211;52<span class="elsevierStyleHsp" style=""></span>U&#47;L&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Her chest X-ray was normal&#44; however&#44; multiple mediastinal and hilar lymph nodes with the greatest dimension of 1<span class="elsevierStyleHsp" style=""></span>cm was identified in her thoracic CT &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Results were consistent with stage 1 sarcoidosis&#46; Regarding the patient&#39;s history&#44; the FMF mutation tests were requested&#46; In the FMF gene analysis all M694V&#44; E148Q&#44; R202Q mutations were found in the heterozygous state&#46; After the clinical&#44; radiological&#44; and genetic observation and results of the laboratory test&#44; diagnosis of sarcoidosis with FMF was considered&#46; We made differential diagnosis&#59; lymphoma&#44; infection&#44; other rheumatic diseases &#40;such as connective tissue diseases&#41; were exluded according to investigations&#46; Three times daily oral treatment with NSAIDs and Colchicine 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg tablets was initiated&#46; In her follow-up examination after 3 months&#44; a significant regression in her clinical symptoms was observed and she reported that there are no abdominal pain or fever attacks&#46; Control acute phase reactants were investigated and the levels were determined as normal&#46; Outpatient follow-up is still in progress for the patient with representing overall good condition&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">In this paper&#44; we reported the comorbidity of sarcoidosis and FMF&#46; Until now&#44; only a few cases reported comorbidity of sarcoidosis and FMF&#46; As a result of their investigation&#44; Erten et al&#46; diagnosed acute sarcoidosis &#40;L&#246;fgren syndrome&#41; and FMF together in 61 years old patient who admitted with the presence of erythema nodosum and recurrent fever and abdominal pain attacks&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Corticosteroids&#44; methotrexate&#44; colchicine controlled the patient&#39;s complaints after the treatment&#46; Aktimur et al&#46; reported that a 53 years old patient who was monitored with FMF diagnosis and had appendectomy 34 years ago was diagnosed with sarcoidosis based on biopsy from scar tissue and pathological evaluations&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Scar sarcoidosis was considered for this patient with no systemic symptoms and he was just monitored&#46; In another report&#44; 42 years old male patient using IFN-alpha due to the FMF was subjected to thorax CT due to the development of exertional dyspnea showed bilateral hilar lymphadenopathy&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Depending on his histopathological evaluation&#44; he was diagnosed with sarcoidosis and a causal relationship tried to be established between disease and medication&#46; In literature&#44; the development of sarcoidosis in patients treated with anti-TNF-alpha is also reported&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> In our case&#44; without any drug relationship&#44; we reported the coexistence of sarcoidosis and FMF&#46; However&#44; the presence of MEFV mutation may cause symptoms other than FMF and&#47;or may determine the course and prognosis of some rheumatologic diseases&#46; Sever et al&#46; investigated mutation frequency of MEFV gene in patients with sarcoidosis&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Low frequency of MEFV gene mutation was reported in patients with sarcoidosis compared the control group&#46; This gene is thought to have a protective effect with respect to sarcoidosis because it less frequently occurs in patient with sarcoidosis than normal Turkish population&#46; Sarcoidosis is a granulomatous disease with different clinical features&#46; The etiology of sarcoidosis is unknown&#44; however&#44; it is suggested that genetic and immunologic factors might have an important role in the development of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> The low virulence due to the inadequate immune response causes the formation of permanent antigen&#46; As a result of Th1 mediated immune response&#44; development of accumulation of lymphocytes&#44; macrophages and mononuclear phagocytes and non-caseating granulomas formation occurs in the affected organ&#46; On the other hand&#44; FMF is an autosomal recessive autoinflammatory disease&#44; characterized by recurrent episodes of fever and polyserositis&#46; The underlying cause of the disease is the mutation in MEFV gene which codes for proteins called pyrin or marenostrin&#46; There is no common connection between sarcoidosis and FMF&#46; Early-onset sarcoidosis &#40;Blau syndrome&#41; is also an autoinflammatory disease like FMF&#46; The pathogenesis of Blau syndrome revealed that NOD2&#47;CARD15 gene mutations cause the disease&#46; Possibilities of different clinical presentations of the same disease in adults with sarcoidosis are discussed in the literature&#46; In adult sarcoidosis&#44; the presence of self-limited acute skin lesions&#44; locomotor system symptoms and the regression of non-treatable disease suggest that this may be an autoinflammatory disease&#46; Therefore&#44; it may have common features and&#47;or etiopathogenesis&#46; In fact&#44; while our patient already has sarcoidosis&#44; she also diagnosed with FMF after gene analysis&#46; In conclusion&#44; the coexistence of sarcoidosis and FMF have been reported in few cases in the literature&#46; The fact that both diseases are chronic and inflammatory suggesting the possibility of common etiopathogenesis and&#47;or coincidence&#46; New studies are necessary for investigation of this subject&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Ethical disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Protection of human and animal subjects</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare and guarantee that they are in possession of a document signed by the patients whose personal data is included in the article&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare not any conflict of interest or financial support&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sarcoidosis is a chronic inflammatory disease with unknown cause characterized by non-caseating granuloma formations&#46; It may present with bilateral hilar lymphadenopathy&#44; skin lesions&#44; the involvement of eye and symptoms on the locomotor system&#46; FMF &#40;Familial Mediterranean Fever&#41; is an autosomal recessive autoinflammatory disease&#44; characterized by recurrent episodes of fever and polyserositis&#46; Simultaneous occurrence of these diseases is rare&#46; In this paper&#44; we reported the coexistence of sarcoidosis with FMF&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La sarcoidosis es una enfermdad inflamatoria cr&#243;nica de origen desconocido caracterizada por formaciones de granulomas no caseificantes&#46; Puede manifestarse con linfadenopat&#237;a hiliar bilateral&#44; lesiones cut&#225;neas&#44; afectaci&#243;n ocular y s&#237;ntomas en el aparato locomotor&#46; La FMF &#40;fiebre mediterr&#225;nea familiar&#41; es una enfermedad inflamatoria autos&#243;mica recesiva que se caracteriza por episodios recurrentes de fiebre y poliserositis&#46; La concurrencia simult&#225;nea de ambas patolog&#237;as es poco frecuente&#46; En este art&#237;culo se presenta la coexistencia de sarcoidosis con FMF&#46;</p></span>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;9<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">WBC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ALT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23<span class="elsevierStyleHsp" style=""></span>U&#47;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27<span class="elsevierStyleHsp" style=""></span>U&#47;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcium&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#8211;0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ESR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RF&nbsp;\t\t\t\t\t\t\n
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      "titulo" => "References"
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              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medical progress&#58; sarcoidosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;S&#46; Newman"
                            1 => "C&#46;S&#46; Rose"
                            2 => "L&#46;A&#46; Maier"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1056/NEJM199704243361706"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1997"
                        "volumen" => "336"
                        "paginaInicial" => "1224"
                        "paginaFinal" => "1234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9110911"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A candidate gene for familial Mediterranean fever"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "The French FMF consortium"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ng0997-25"
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                        "tituloSerie" => "Nat Genet"
                        "fecha" => "1997"
                        "volumen" => "17"
                        "paginaInicial" => "25"
                        "paginaFinal" => "31"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9288094"
                            "web" => "Medline"
                          ]
                        ]
                      ]
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                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "The International FMF consortium"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cell"
                        "fecha" => "1997"
                        "volumen" => "90"
                        "paginaInicial" => "797"
                        "paginaFinal" => "807"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9288758"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pyrin&#47;Marenostrin mutations in familial Mediterranean fever"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;R&#46; Booth"
                            1 => "J&#46;D&#46; Gillmore"
                            2 => "M&#46;B&#46; Booth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
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Case report
Coexistence of sarcoidosis and Familial Mediterranean Fever
Coexistencia de sarcoidosis y fiebre mediterránea familiar
Hüseyin Semiz, Senol Kobak
Autor para correspondencia
senolkobak@gmail.com

Corresponding author at: Sifa University Faculty of Medicine, Department of Rheumatology, 35100-Bornova/Izmir, Turkey.
Sifa University, Faculty of Medicine, Department of Rheumatology, Turkey
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            "correspondencia" => "Corresponding author at&#58; Sifa University Faculty of Medicine&#44; Department of Rheumatology&#44; 35100-Bornova&#47;Izmir&#44; Turkey&#46;"
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        "titulo" => "Coexistencia de sarcoidosis y fiebre mediterr&#225;nea familiar"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Sarcoidosis is a chronic inflammatory disease with unknown cause characterized by non-caseating granuloma formations&#46; It may present with bilateral hilar lymphadenopathy&#44; skin lesions&#44; the involvement of eye and symptoms on the locomotor system&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Familial Mediterranean Fever &#40;FMF&#41; is commonly seen autoinflammatory disease with an autosomal recessive pattern of inheritance&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> The disease is characterized by clinically recurrent fever and polyserositis attacks and pathogenically a mutation in the MEFV gene which is located on short arm of chromosome 16 causes the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> FMF primarily affects Turkish&#44; Armenian&#44; Arab and Jewish populations&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> In this paper we mentioned about a patient with sarcoidosis who was monitored for 10 years was diagnosed with FMF in addition to sarcoidosis as a result of the examination of her recent increasing complaints&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">50 years old female patient who was diagnosed with sarcoidosis 10 years ago was admitted to our rheumatology clinic with complaints of fatigue&#44; recurrent fever&#44; dry cough&#44; and arthralgia&#46; During her examination&#44; she described recurrent abdominal pain and fever attacks which occur since her childhood&#46; There is no known feature in her family history and she does not identify FMF in her family&#46; Her medical history revealed that she was examined for a cough and she had a diagnosis of sarcoidosis supported with lymphatic gland biopsy 10 years ago&#46; After 2 years of corticosteroid treatment&#44; her disease restrained&#44; she discontinued to treatment with medication and patient was not present for the subsequent control sessions&#46; Patient&#39;s physical examination showed&#59; 38&#46;5<span class="elsevierStyleHsp" style=""></span>&#176;C fever&#44; sensitivity in both ankles and hip joints and negative results for FABER&#40;Flexion&#44; ABduction&#44; External Rotation&#41; and FADIR&#40;Flexion&#44; ADduction&#44; Internal Rotation&#41; tests&#46; In her systemic examination&#44; rough lung sounds were determined during auscultation&#46; There is palpable lymphadenopathy in her right axillar area&#46; In laboratory tests&#59; fasting blood glucose&#44; liver&#44; and renal functions were normal&#46; CBC&#44; thyroid function tests and routine urinalysis were normal&#46; Acute phase reactants were investigated&#59; C-reactive protein &#40;CRP&#41; was 4&#46;03<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;normal 0&#8211;0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&#44; and sedimentation rate was 43<span class="elsevierStyleHsp" style=""></span>mm&#47;h &#40;normal 0&#8211;20&#41;&#46; In serological tests&#44; negative results for RF&#44; ANA&#44; anti-CCP&#44; ANCA&#44; anti-dsDNA was determined&#46; Hepatitis markers &#40;HBV&#44; HCV&#44; HIV&#41; was normal&#46; Serum ACE level was high &#40;87<span class="elsevierStyleHsp" style=""></span>U&#47;L&#59; normal range&#58; 8&#8211;52<span class="elsevierStyleHsp" style=""></span>U&#47;L&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Her chest X-ray was normal&#44; however&#44; multiple mediastinal and hilar lymph nodes with the greatest dimension of 1<span class="elsevierStyleHsp" style=""></span>cm was identified in her thoracic CT &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Results were consistent with stage 1 sarcoidosis&#46; Regarding the patient&#39;s history&#44; the FMF mutation tests were requested&#46; In the FMF gene analysis all M694V&#44; E148Q&#44; R202Q mutations were found in the heterozygous state&#46; After the clinical&#44; radiological&#44; and genetic observation and results of the laboratory test&#44; diagnosis of sarcoidosis with FMF was considered&#46; We made differential diagnosis&#59; lymphoma&#44; infection&#44; other rheumatic diseases &#40;such as connective tissue diseases&#41; were exluded according to investigations&#46; Three times daily oral treatment with NSAIDs and Colchicine 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg tablets was initiated&#46; In her follow-up examination after 3 months&#44; a significant regression in her clinical symptoms was observed and she reported that there are no abdominal pain or fever attacks&#46; Control acute phase reactants were investigated and the levels were determined as normal&#46; Outpatient follow-up is still in progress for the patient with representing overall good condition&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">In this paper&#44; we reported the comorbidity of sarcoidosis and FMF&#46; Until now&#44; only a few cases reported comorbidity of sarcoidosis and FMF&#46; As a result of their investigation&#44; Erten et al&#46; diagnosed acute sarcoidosis &#40;L&#246;fgren syndrome&#41; and FMF together in 61 years old patient who admitted with the presence of erythema nodosum and recurrent fever and abdominal pain attacks&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Corticosteroids&#44; methotrexate&#44; colchicine controlled the patient&#39;s complaints after the treatment&#46; Aktimur et al&#46; reported that a 53 years old patient who was monitored with FMF diagnosis and had appendectomy 34 years ago was diagnosed with sarcoidosis based on biopsy from scar tissue and pathological evaluations&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Scar sarcoidosis was considered for this patient with no systemic symptoms and he was just monitored&#46; In another report&#44; 42 years old male patient using IFN-alpha due to the FMF was subjected to thorax CT due to the development of exertional dyspnea showed bilateral hilar lymphadenopathy&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Depending on his histopathological evaluation&#44; he was diagnosed with sarcoidosis and a causal relationship tried to be established between disease and medication&#46; In literature&#44; the development of sarcoidosis in patients treated with anti-TNF-alpha is also reported&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> In our case&#44; without any drug relationship&#44; we reported the coexistence of sarcoidosis and FMF&#46; However&#44; the presence of MEFV mutation may cause symptoms other than FMF and&#47;or may determine the course and prognosis of some rheumatologic diseases&#46; Sever et al&#46; investigated mutation frequency of MEFV gene in patients with sarcoidosis&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Low frequency of MEFV gene mutation was reported in patients with sarcoidosis compared the control group&#46; This gene is thought to have a protective effect with respect to sarcoidosis because it less frequently occurs in patient with sarcoidosis than normal Turkish population&#46; Sarcoidosis is a granulomatous disease with different clinical features&#46; The etiology of sarcoidosis is unknown&#44; however&#44; it is suggested that genetic and immunologic factors might have an important role in the development of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> The low virulence due to the inadequate immune response causes the formation of permanent antigen&#46; As a result of Th1 mediated immune response&#44; development of accumulation of lymphocytes&#44; macrophages and mononuclear phagocytes and non-caseating granulomas formation occurs in the affected organ&#46; On the other hand&#44; FMF is an autosomal recessive autoinflammatory disease&#44; characterized by recurrent episodes of fever and polyserositis&#46; The underlying cause of the disease is the mutation in MEFV gene which codes for proteins called pyrin or marenostrin&#46; There is no common connection between sarcoidosis and FMF&#46; Early-onset sarcoidosis &#40;Blau syndrome&#41; is also an autoinflammatory disease like FMF&#46; The pathogenesis of Blau syndrome revealed that NOD2&#47;CARD15 gene mutations cause the disease&#46; Possibilities of different clinical presentations of the same disease in adults with sarcoidosis are discussed in the literature&#46; In adult sarcoidosis&#44; the presence of self-limited acute skin lesions&#44; locomotor system symptoms and the regression of non-treatable disease suggest that this may be an autoinflammatory disease&#46; Therefore&#44; it may have common features and&#47;or etiopathogenesis&#46; In fact&#44; while our patient already has sarcoidosis&#44; she also diagnosed with FMF after gene analysis&#46; In conclusion&#44; the coexistence of sarcoidosis and FMF have been reported in few cases in the literature&#46; The fact that both diseases are chronic and inflammatory suggesting the possibility of common etiopathogenesis and&#47;or coincidence&#46; New studies are necessary for investigation of this subject&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Ethical disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Protection of human and animal subjects</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare and guarantee that they are in possession of a document signed by the patients whose personal data is included in the article&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare not any conflict of interest or financial support&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sarcoidosis is a chronic inflammatory disease with unknown cause characterized by non-caseating granuloma formations&#46; It may present with bilateral hilar lymphadenopathy&#44; skin lesions&#44; the involvement of eye and symptoms on the locomotor system&#46; FMF &#40;Familial Mediterranean Fever&#41; is an autosomal recessive autoinflammatory disease&#44; characterized by recurrent episodes of fever and polyserositis&#46; Simultaneous occurrence of these diseases is rare&#46; In this paper&#44; we reported the coexistence of sarcoidosis with FMF&#46;</p></span>"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La sarcoidosis es una enfermdad inflamatoria cr&#243;nica de origen desconocido caracterizada por formaciones de granulomas no caseificantes&#46; Puede manifestarse con linfadenopat&#237;a hiliar bilateral&#44; lesiones cut&#225;neas&#44; afectaci&#243;n ocular y s&#237;ntomas en el aparato locomotor&#46; La FMF &#40;fiebre mediterr&#225;nea familiar&#41; es una enfermedad inflamatoria autos&#243;mica recesiva que se caracteriza por episodios recurrentes de fiebre y poliserositis&#46; La concurrencia simult&#225;nea de ambas patolog&#237;as es poco frecuente&#46; En este art&#237;culo se presenta la coexistencia de sarcoidosis con FMF&#46;</p></span>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;9<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;8&#8211;14&#46;9<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">WBC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Platelet count&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#8211;20<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;5&#8211;0&#46;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;4&#8211; 7<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ALT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23<span class="elsevierStyleHsp" style=""></span>U&#47;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27<span class="elsevierStyleHsp" style=""></span>U&#47;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;6&#8211;10&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Albumin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
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