PFAPA SENDROMU - ORAL BULGULARI VE DENTAL TEDAVI PROTOKOLÜ
Bu
olgu sunumunda amaç,
PFAPA sendromlu lenfadenopati şikayeti ile kliniğimize başvuran bir hastanın,
klinik ve radyografik kayıtlarını rapor etmek ve ilgili literatürleri gözden
geçirmektir.
PFAPA
sendromu tekrarlayan ve periodik ateşlerle seyreden, ani başlayan yüksek ateş,
aftöz stomatit, farenjit ve servikal lenfadenopati ile karakterize bir
sendromdur. Genellikle 5 yaş altı çocuklarda ani bir başlangıç gösterir. 10 yaş
öncesi hastalığın kendiliğinden gerilediği bildirilmiştir. Oral bulgular
arasında aftöz stomatit bulunması sebebiyle hastalar çocuk diş hekimine
sıklıkla başvurur.
Olgumuzda
PFAPA sendromu tanısı konulmuş kronolojik yaşı 6 yaş 7 ay olan kız hastanın
oral bulguları, büyüme ve gelişimi değerlendirilmiştir. Hastalığın ağız içi
bulguları ve ataklar esnasında geçirilen febril konvülsiyonlar nedeniyle, bu
hastalarda özel bir diş hekimliği yaklaşımı gerektirir.
Anahtar
Kelimeler:
PFAPA Sendromu, aftöz stomatit, lenfadenopati
PFAPA SYNDROME - ORAL MANIFESTATIONS AND A DENTAL TREATMENT PROTOCOLABSTRACTThe purpose of this case
report is to report the clinical and radiographic records of a patient who applied to our clinic with PFAPA syndrome and with cervical
lymphadenopathy complaints, and also to review the relevant literature.Periodic Fever, Aphthous Stomatitis, Pharyngitis,
Cervical Adenitis (PFAPA) is a recurrent syndrome that consists of episodic
fever and characterized by abruptly starting fevers, aphthous stomatitis,
pharyngitis, and cervical lymphadenopathy. PFAPA usually starts suddenly in the children
under the age of 5 years. However, it has been reported that the disease had
been resolved by itself, after the age of 10 years. Since aphthous stomatitis
is among the oral symptoms, patients frequently apply to pediatric dentistry
clinics.In our case report, growth and development and oral
findings of a girl diagnosed with PFAPA and with a chronological age of 6 years
7 months, were evaluated. Due to the oral manifestations of PFAPA and febrile
convulsion attacks, a special dental approach is required to the patients with
PFAPA.
Key Words: PFAPA syndrome, aphthous stomatitis, lymphadenopathy
___
- 1- Marshall GS, Edwars KM, Butler J, Lawton AR. Syndrome of periodic fever, pharyngitis and aphthous stomatitis. J Pediatry 1987; 110: 43-6.
- 2- Long SS. Syndrome of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) - what it isn’t. What is it? J Pediatr 1999;135:98–101.
- 3- Padeh S, Brezniak N, Zemer D, et al. Periodic fever, aphthous stomatitis, pharyngitis and adenopathy syndrome: clinical characteristics and outcome. J Pediatr1999;135:98–101.
- 4- Pinto A, Lindemeyer R.G., and Sollecito T.P. The PFAPA syndrome in oral medicine: Differential diagnosis and treatment. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 2006; 102 : 35-9.
- 5- Thomas KT, Feder HM Jr, Lawton AR, Edwards KM. Periodic fever syndrome in children. J Pediatr 1999; 135:15-21.
- 6- Atas B, Caksen H, Arslan S, Tuncer O, Kirimi E, Odabas D. PFAPA syndrome mimicking familial Mediterranean fever: re- port of a Turkish child. J Emerg Med 2003;25:383-5.
- 7- Silvia Stojanov, Florian Hoffmann, Anja Kéry, Ellen D Renner, Dominik Hartl, Peter Lohse, Kristina Huss, Peter Fraunberger, James D Malley, Stephanie Zellerer, Michael H Albert, Bernd H Belohradsky. Cytokine profile in PFAPA syndrome suggests continuous inflammation and reduced anti-inflammatory response. European Cytokine Network. 2006;17:90-7.
- 8- Feder Jr. HM. Cimetidine treatment for periodic fever associated with aphthous stomatitis, pharyngitis and cervical adenitis. Pediatr Infect Dis J 1992; 11: 318.
- 9- Ovetchine P, Bry ML, Reinert P. Marshall syndrome: results of a retrospective national survey. Arch Pediatr 2000; 7: 578s.
- 10- Dahn KA, Glode MP, Chan KH. Periodic fever and pharyngitis in young children: a new disease for the otolaryngologist? Arch Otolaryngol Head Neck Surg 2000; 126: 1146