To the Editor.Ìý —We would like to report the following case of familial Mediterranean fever (FMF) with pleuropericarditis, nephrotic syndrome, sensitivity to indomethacin, and unexplained hyperkalemia.

Report of a Case.Ìý —A 57-year-old man was admitted because of severe edema and pleuropericardial effusion. His past history showed that he had undergone surgery because of suspected peritonitis and had undergone small-bowel resection. He suffered from recurrent arthritis and, because of high levels of serum uric acid with proteinuria and mild renal failure, he was labeled as having "gouty kidney." Concomitantly, high true serum potassium levels around 6.5 to 7.5 mEq/L were found, for which polystyrene sodium sulfonate (Kayexalate) was continuously given. He repeatedly denied any contributory family history, but later we found that some members of his tribe had FMF.On admission, the patient was in moderate respiratory distress, with respirations of 32/min. His weight was 58 kg; temperature, 37.5 °C; blood