Superior vena cava thrombosis and obstructive sleep apnea in a patient with familial Mediterranean fever.

Familial Mediterranean fever (FMF), a paroxysmal, self-limited, inflammatory disease of unknown etiology, may result in thrombotic complications after the development of nephrotic syndrome due to amyloidosis. It has been suggested that there is increased thrombogenic activity in the blood of patients with FMF who did not develop nephrotic syndrome. We describe a patient with FMF who presented with thrombosis in the superior vena cava (SVC) in the absence of nephrotic syndrome, and discuss the contributory role of increased procoagulant activity detected in this disorder. Moreover, the patient was proved to have obstructive sleep apnea (OSA) which we believe was secondary to SVC thrombosis that lead to soft tissue edema in the upper airways. To our knowledge, this is the second reported case in the literature in which OSA occurred secondary to the SVC thrombosis.