Clinic entity that should not be forgotten in children with high fever; PFAPA syndrome

Clinic entity that should not be forgotten in children with high fever; PFAPA syndrome

Aim: PFAPA syndrome which we thought was not well recognized. The high fever clinic of PFAPA syndrome usually mimics infectious conditions therefore it can lead to unnecessary and costly diagnostic tests and treatments. We evaluated the medical history, clinical findings and outcomes of pediatric patients diagnosed with PFAPA syndromeMaterial and Methods: In Mustafa Kemal University, Faculty of Medicine, Department of Pediatrics between September of 2016 and 2017, demographics, clinical, laboratory, diagnosis and treatment data of our patients diagnosed with PFAPA syndrome were retrospectively reviewed.Results: 68 patients were studied in our study, of which 27 (39.7%) were females and 41 (6.2%) were males. The mean age at onset of symptoms was 21.7 months. The mean age of diagnosis was 34.9 months. The mean duration between episodes of the disease was 27.05 days and the mean duration of episodes was 4.91 days.Conclusion: PFAPA syndrome which causes unnecessary costly examinations and treatments should be kept in mind in high fever clinic and also medical treatment was found to be effective in patients with PFAPA syndrome.

___

  • 1. Nield LS, Kamat D. Fever. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF..Nelson Textbooks of Pediatrics. 20th edition. Philadelphia: Elsevier 2016. p. 1277-9.
  • Semianchuk VB, Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome in children. Eur 2017;70:144-7.
  • 3. Marshall GS, Edwards KM, Butler J, et al. Syndrome of periodic fever, pharyngitis, and aphthous stomatitis. J Pediat 1987;110:43-6.
  • 4. Thomas KT, Feder HM Jr, Lawton AR, et al. Periodic fever syndrome in children. J pediat 1999;135:15-21.
  • 5. Galanakis E, Papadakis CE, Giannoussi E, et al. PFAPA syndrome in children evaluated for tonsillectomy. Arc Dis Child 2002;86:434-5.
  • 6. Feder HM Jr. Periodic fever, aphthous stomatitis, pharyngitis, adenitis: a clinical review of a new syndrome. Curr Opin Pediat 2000;12:253-56.
  • 7. Król P, Böhm M, Sula V, et al. PFAPA syndrome: clinical characteristics and treatment outcomes in a large single-centre cohort. Clin Exp Rheumatol 2013;31:980-7.
  • 8. Ombrello AK, Kastner DL. Hereditary Periodic fever syndromes and other systemic autoinflammatory diseases. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF.Nelson Textbooks of Pediatrics. 20th edition. Philadelphia: Elsevier 2016. p. 1193-204.
  • 9. Mansour I1, Delague V, Cazeneuve C, et al., Familial Mediterranean fever in Lebanon: mutation spectrum, evidence for cases in Maronites, Greek orthodoxes, Greek catholics, Syriacs and Chiites and for an association between amyloidosis and M694V and M694I mutations. Eur J Hum Genet 2001;9:51-5.
  • 10. Nir-Paz R1, Ben-Chetrit E, Pikarsky E, et al. Unusual presentation of familial Mediterranean fever: role of genetic diagnosis. Ann Rheum Dis 2000;59:836-8.
  • 11. Long SS, Syndrome of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA)- what it isn’t. What is it? J Pediat 1999;135:1-5.
  • 12. Padeh S, Brezniak N, Zemer D, et al, Periodic fever, aphthous stomatitis, pharyngitis, and adenopathy syndrome: clinical characteristics and outcome. J Pediat 1999;135:98-101.
  • 13. Manthiram K, Li SC, Hausmann JS, et al, Physicians’ perspectives on the diagnosis and management of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome. Rheumatol Int 2017;37:883-89.
  • 14. Masters SL, Simon A, Aksentijevich I, et al. Horror autoinflammaticus: the molecular pathophysiology of autoinflammatory disease. Annual review of immunology, 2009;27:621-8.
  • 15. Jacobs Z, Ciaccio CE, Periodic fever syndromes. Curr Allergy Asthma Rep 2010;10:398-404.
  • 16. Padeh S, Berkun Y, Auto-inflammatory fever syndromes. Rheum Dis Clin 2007;33:585-623.
  • 17. John CC, Gilsdorf JR. Recurrent fever in children. Pediatr Infect Dis J 2002;21:1071-7.
  • 18. Brown KL, Wekell P, Osla V, et al., Profile of blood cells and inflammatory mediators in periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome. BMC Pediatr 2010;10:65.
  • 19. Gattorno M, Caorsi R, Meini A, et al, Differentiating PFAPA syndrome from monogenic periodic fevers. Pediatrics 2009;124:721-8.
  • 20. Stojanov S1, Hoffmann F, Kéry A, et al., Cytokine profile in PFAPA syndrome suggests continuous inflammation and reduced anti-inflammatory response. Eur Cytokine Netw 2006;17:90-7.
  • 21. Adachi M, Watanabe A, Nishiyama A, et al., Familial cases of periodic fever with aphthous stomatitis, pharyngitis, and cervical adenitis syndrome. J Pediatr 2011;158:155-9.
  • 22. Dusser P, Hentgen V, Neven B, Is colchicine an effective treatment in periodic fever, aphtous stomatitis, pharyngitis, cervical adenitis (PFAPA) syndrome? Joint Bone Spine 2016;83:406-11.
  • 23. Feder HM Jr. Cimetidine treatment for periodic fever associated with aphthous stomatitis, pharyngitis and cervical adenitis. Pediatr Infect Dis J 1992;11:318-21.
  • 24. Licameli G, Jeffrey J, Luz J. Effect of adenotonsillectomy in PFAPA syndrome. Arc Otolaryngol Head Neck Surg 2008;134:136-40.
  • 25. Renko M1, Salo E, Putto-Laurila A, et al. A randomized, controlled trial of tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome. J Pediatr 2007;151:289-92.
  • 26. Feder HM, Salazar JC, A clinical review of 105 patients with PFAPA (a periodic fever syndrome). Acta paediatr 2010;99:178-84.
  • 27. Tekin M, Toplu Y, Gülyüz A, et al. Periyodik Ateş, Aftöz Stomatit, Farenjit, Servikal Adenit (PFAPA) Sendromlu Hastaların Uzun Dönem Takip Sonuçlarının Deðerlendirilmesi. Turkiye Klinikleri J Pediatr 2014;23:10-5.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

The relationship between preoperative and postoperative neutrophil-lymphocyte and platelet-lymphocyte ratio with post-dural-puncture headache in patients undergoing cesarean section

Mehmet Selcuk ULUER, Mahmut Sami TUTAR, Mehmet SARGİN

Gastrointestinal system-derived secondary gynecologic tumors: 10 years experience at a single center

Huseyin Caglayan OZCAN, Zehra BOZDAĞ, Özcan BALAT, Neslihan BAYRAMOĞLU TEPE

Association between coronary artery disease and responsiveness of aortic stiffness and pulsatile diameter change to nitroglycerin

Veli Gökhan CİN, Ibrahim YILDIZ, Pınar ÖZMEN YILDIZ

Surgical therapy of medullary thyroid cancer and our clinical experiences

Hakan YABANOGLU, Tevfik AVCI, Nazim Emrah KOCER, Ilker Murat ARER, Aydincan AKDUR, Abdirahman Sakulen HARGURA

Predictive value of neutrophil-to-lymphocyte ratio before the second biopsy while detecting atypical small acinar proliferation

Caner EDİZ, Ayse Nur IHVAN

Demographics and clinical characteristic of patients diagnosed with hen’s egg allergy

Mustafa ARGA, Mustafa Sinan KAYNAK, Yucel DUMAN, Mehmet Halil CELİKSOY, Huri Maral DALKILIC, Cem ALATAŞ, Semih DEMİRTAŞ, Hayrettin TONBUL, Erdem TOPAL

Long anatomical femoral stem reduces stress concentrations on femurs with lateral bowing deformity: A finite element analysis

Turan Cihan DÜLGEROĞLU, Nihat Demirhan DEMİRKIRAN, Mehmet ERDURAN

Stomach metastasis of malignant melanoma

Mustafa DİKİLİTAŞ, Mehmet Ali ERDOGAN, Elkin MEHRALİYEV, Yasir Furkan CAGİN, Ayşenur AKATLI, Murat Muhsin HARPUTLUOGLU, Yilmaz BİLGİC, Bahri EVREN

Clinic entity that should not be forgotten in children with high fever; PFAPA syndrome

Çiğdem EL, Mehmet Emin ÇELİKKAYA

Foreign-body aspiration mimicking asthma in pre-school age group: A case report

Hakki ULUTAŞ, Muhammet Reha ÇELİK, Mehmet Yavuz ÖZBEY, Erdem TOPAL